Individual provider Active NPI

Jennifer Chieh Lin, DDS

  • Dentist
  • Tustin, CA
National Provider Identifier
1366052540
Registry record updated Aug 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
105158 Issued in CA
Practice address
14771 Plaza Dr Ste D
Tustin, CA 92780-2779
Phone
(714) 616-4416
NPI assigned
Aug 3, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 105158 CA Primary

Addresses

Primary practice location

14771 Plaza Dr Ste D
Tustin, CA 92780-2779

Mailing address

14771 Plaza Dr Ste D
Tustin, CA 92780-2779
Phone (714) 616-4416

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
105158CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Gina Tuyet Nguyen DDS PC CurrentSince Jan 7, 2024 Accepting new patients

Locations

14771 Plaza Dr
Ste D
Tustin, CA 92780
Phone (714) 616-4416

Organizations & group practices 1

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": "1596412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596412800000",
    "number": "1366052540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14771 PLAZA DR STE D",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927802779",
            "telephone_number": "714-616-4416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14771 PLAZA DR STE D",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927802779",
            "telephone_number": "714-616-4416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIN",
        "first_name": "JENNIFER",
        "middle_name": "CHIEH",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-03",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "105158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.