Individual provider Active NPI

Benjamin Lin, DMD

  • Dentist
  • Rocklin, CA
National Provider Identifier
1336893833
Registry record updated Jul 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
108945 Issued in CA
Practice address
5182 Commons Dr
Rocklin, CA 95677-3911
Phone
(916) 660-9487
NPI assigned
Feb 4, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 108945 CA Primary

Addresses

Primary practice location

5182 Commons Dr
Rocklin, CA 95677-3911

Mailing address

5182 Commons Dr Unit 101
Rocklin, CA 95677-3911
Phone (248) 421-1858

Other practice location 1

3291 Stanford Ranch Rd Ste 102
Rocklin, CA 95765-5577
Phone (916) 435-1665

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20220816003171 OH Order and Referring Only - DentistPractitioner - Dentist 8123401635

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
108945CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Rodgers and Ghazal Dental Corporation Past Accepting new patients
Ricky V Tran Dental Corporation PastSince Jul 16, 2023 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1643932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689033600000",
    "number": "1336893833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5182 COMMONS DR UNIT 101",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "956773911",
            "telephone_number": "248-421-1858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5182 COMMONS DR",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "956773911",
            "telephone_number": "916-660-9487"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3291 Stanford Ranch Rd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Rocklin",
            "state": "CA",
            "postal_code": "957655577",
            "country_code": "US",
            "telephone_number": "916-435-1665",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIN",
        "first_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-02-04",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "108945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocklin, CA

Sources for this page

Verify at the official NPI Registry.