Individual provider Active NPI

Brian Lin, D.M.D.

  • General Practice Dentistry
  • Bellevue, WA
National Provider Identifier
1407294804
Registry record updated Nov 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
11248 Issued in CT
Practice address
12360 NE 8TH St Ste 250
Bellevue, WA 98005-4802
Phone
(425) 253-2222
NPI assigned
Jun 6, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DE60881688 WA
General Practice Dentistry 1223G0001X 11248 CT Primary

Addresses

Primary practice location

12360 NE 8TH St Ste 250
Bellevue, WA 98005-4802

Mailing address

123 York St
Suite 4L
New Haven, CT 06511-5614
Phone (516) 415-2588

Other practice location 1

8119 Greenwood Ave N # 4230
Seattle, WA 98103-4230
Phone (206) 784-4800

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
DE60881688WAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
New Haven Dental Group General Practice Past Accepting new patients

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": "1370476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636243200000",
    "number": "1407294804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 YORK ST",
            "address_2": "SUITE 4L",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065115614",
            "telephone_number": "516-415-2588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12360 NE 8TH ST STE 250",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980054802",
            "telephone_number": "425-253-2222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8119 Greenwood Ave N # 4230",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981034230",
            "country_code": "US",
            "telephone_number": "206-784-4800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIN",
        "first_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-06",
        "last_updated": "2021-11-07",
        "certification_date": "2021-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60881688",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "11248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2021; 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.