Organization Active NPI

Marian T Lin DDS P S Inc

  • Dental Clinic/Center
  • Renton, WA
National Provider Identifier
1619333853
Registry record updated Jan 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
DE00009812 Issued in WA
Legal business name
MARIAN T LIN DDS P S INC
Practice address
1620 Duvall Ave NE
Ste 200
Renton, WA 98059-3975
Phone
(425) 271-7121
Fax
(425) 271-7130
NPI assigned
Jan 4, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2016

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

Authorized official

Name
Dr. Marian T Lin, DDS
Title
President/Owner
Phone
(425) 271-7121

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X DE00009812 WA Primary

Addresses

Primary practice location

1620 Duvall Ave NE
Ste 200
Renton, WA 98059-3975

Mailing address

1620 Duvall Ave NE
Ste 200
Renton, WA 98059-3975
Phone (425) 271-7121

Other identifiers 1

IdentifierTypeStateIssuer
5049036MedicaidWA

National Provider Directory

National Provider Directory

Locations

1620 Duvall Ave NE
Ste 200
Renton, WA 98059
Phone (425) 264-4030

NPI Registry JSON

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

{
    "created_epoch": "1451865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451865600000",
    "number": "1619333853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 DUVALL AVE NE",
            "address_2": "STE 200",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980593975",
            "telephone_number": "425-271-7121",
            "fax_number": "425-271-7130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 DUVALL AVE NE",
            "address_2": "STE 200",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980593975",
            "telephone_number": "425-271-7121",
            "fax_number": "425-271-7130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIAN T LIN DDS P S INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-04",
        "last_updated": "2016-01-04",
        "status": "A",
        "authorized_official_last_name": "LIN",
        "authorized_official_first_name": "MARIAN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "425-271-7121",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "WA",
            "license": "DE00009812",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5049036",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2016; 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.