Individual provider Active NPI

Stanley Wang Lin, DDS

  • Dentist
  • Austin, TX
National Provider Identifier
1518375781
Registry record updated Oct 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
34519 Issued in TX
Practice address
Southpark Meadows Dental Group and Orthodontics
401 West Slaughter Lane #200
Austin, TX 78748
Phone
(512) 291-8012
NPI assigned
Jul 31, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 91016679921 UT
Dentist 122300000X 34519 TX Primary

Addresses

Primary practice location

Southpark Meadows Dental Group and Orthodontics
401 West Slaughter Lane #200
Austin, TX 78748

Mailing address

Southpark Meadows Dental Group and Orthodontics
401 West Slaughter Lane #200
Austin, TX 78748
Phone (512) 291-8012

Other practice location 1

Southpark Meadows Dental Group and Orthodontics
401 West Slaughter Lane #200
Austin, TX 78748
Phone (512) 291-8012

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20190426001205 TX Order and Referring Only - DentistPractitioner - Dentist 4880936681

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34519TXMDPsychologist
91016679921UTMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
SPM Dental Group and Orthodontics, PC Dentist 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": "1406764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538352000000",
    "number": "1518375781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "SOUTHPARK MEADOWS DENTAL GROUP AND ORTHODONTICS",
            "address_2": "401 WEST SLAUGHTER LANE #200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78748",
            "telephone_number": "512-291-8012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SOUTHPARK MEADOWS DENTAL GROUP AND ORTHODONTICS",
            "address_2": "401 WEST SLAUGHTER LANE #200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78748",
            "telephone_number": "512-291-8012"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Southpark Meadows Dental Group and Orthodontics",
            "address_2": "401 West Slaughter Lane #200",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "78748",
            "country_code": "US",
            "telephone_number": "512-291-8012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIN",
        "first_name": "STANLEY",
        "middle_name": "WANG",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-31",
        "last_updated": "2018-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "91016679921",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "34519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.