Individual provider Active NPI

Lin Rajoub, DOCTOR

  • Dentist
  • Bellflower, CA
National Provider Identifier
1306339098
Registry record updated Sep 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
103044 Issued in CA
Practice address
9755 Alondra Blvd
Bellflower, CA 90706-3677
Phone
(714) 423-5339
NPI assigned
Jun 7, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training ProgramGroup: 193200000X MULTI-SPECIALTY GROUP 390200000X
Dentist 122300000X 103044 CA Primary

Addresses

Primary practice location

9755 Alondra Blvd
Bellflower, CA 90706-3677

Mailing address

9755 Alondra Blvd
Bellflower, CA 90706-3677
Phone (310) 483-3937

Other practice location 1

11755 Collar Ave
Tustin, CA 92782-3373
Phone (310) 483-3937

Other names 1

  • Lin Rajoub Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260224002069 CA Order and Referring Only - DentistPractitioner - Dentist 9931680303

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
103044CAMDMarriage & Family Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1528329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537401600000",
    "number": "1306339098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9755 ALONDRA BLVD",
            "city": "BELLFLOWER",
            "state": "CA",
            "postal_code": "907063677",
            "telephone_number": "310-483-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9755 ALONDRA BLVD",
            "city": "BELLFLOWER",
            "state": "CA",
            "postal_code": "907063677",
            "telephone_number": "714-423-5339"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11755 Collar Ave",
            "address_purpose": "LOCATION",
            "city": "Tustin",
            "state": "CA",
            "postal_code": "927823373",
            "country_code": "US",
            "telephone_number": "310-483-3937",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAJOUB",
        "first_name": "LIN",
        "credential": "DOCTOR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-07",
        "last_updated": "2018-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "103044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LIN",
            "last_name": "RAJOUB",
            "credential": "DOCTOR",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Bellflower, CA

Sources for this page

Verify at the official NPI Registry.