Individual provider Active NPI

Albert W Lin, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Poway, CA
National Provider Identifier
1427135417
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
46406 Issued in CA
Practice address
12630 Monte Vista Rd Ste 205
Poway, CA 92064-2527
Phone
(858) 485-1290
Fax
(858) 675-7485
NPI assigned
Nov 1, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 46406 CA Primary

Addresses

Primary practice location

12630 Monte Vista Rd Ste 205
Poway, CA 92064-2527

Mailing address

12630 Monte Vista Rd Ste 205
Poway, CA 92064-2527
Phone (858) 485-1290

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Feb 16, 2017 through Feb 16, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
46406CAMDOral and Maxillofacial Surgery (Dentist)

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427135417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12630 MONTE VISTA RD STE 205",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642527",
            "telephone_number": "858-485-1290",
            "fax_number": "858-675-7485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12630 MONTE VISTA RD STE 205",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642527",
            "telephone_number": "858-485-1290",
            "fax_number": "858-675-7485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIN",
        "first_name": "ALBERT",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "46406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poway, CA

Sources for this page

Verify at the official NPI Registry.