Calvin Tao Lin, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS041810 Issued in PA

Practice address

230 N Keswick Ave # B
Glenside, PA 19038-4804

Phone

(215) 885-4252

NPI assigned

Apr 12, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Dynamic Modern Dentistry at Keswick Village PLLC

  • General Practice Dentistry
  • Glenside, PA
  • NPI 1336000298
  NPD Authorized official
• Dynamic Modern Dentistry

  • General Practice Dentistry
  • Glenside, PA
  • NPI 1578714812
  NPD (past)
• McMurray Dental

  • General Practice Dentistry
  • MC Murray, PA
  • NPI 1992970420
  NPD (past)

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

{
    "created_epoch": "1523491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670371200000",
    "number": "1508363870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 N KESWICK AVE",
            "city": "GLENSIDE",
            "state": "PA",
            "postal_code": "190384804",
            "telephone_number": "215-885-4252",
            "fax_number": "215-885-7487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 N KESWICK AVE # B",
            "city": "GLENSIDE",
            "state": "PA",
            "postal_code": "190384804",
            "telephone_number": "215-885-4252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIN",
        "first_name": "CALVIN",
        "middle_name": "TAO",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-12",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS041810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA STATE LICENSE",
            "identifier": "DS041810",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Lee
• Kook Sung Lee, D.M.D., M.S.
• Shana Levi-Nielsen, LICENSED PSYCH
• Brian C Ligi, RD, LDN
• Limitless Home Health Care LLC
• Elizabeth Marieanne Lobecker, M.S., CCC-SLP
• Susan E Long, CRNP
• Emily J Lorimer, RDN, LDN
• Julie E Lowe
• Michael Lyons, MD

• General Practice Dentistry in Glenside, PA
• Providers in Glenside, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2022; 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.