Active NPI
David Brock Lynn Jr., D.D.S.
- Periodontics
- Dallas, TX
National Provider Identifier
1639198310
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 12590
- Practice address
- 6190 Lyndon B Johnson Fwy
Suite 900
Dallas, TX 75240-6344 - Phone
- (972) 934-1400
- Fax
- (972) 934-0195
- NPI assigned
- Jul 19, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 12590 | TX | Primary |
Addresses
Primary practice location
6190 Lyndon B Johnson Fwy
Suite 900
Dallas, TX 75240-6344
Mailing address
6190 Lyndon B Johnson Fwy
Suite 900
Dallas, TX 75240-6344
Phone (972) 934-1400
Other names 1
- Dr. David Brock Lynn Jr.
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171117002640 | TX | Order and Referring Only - Dentist | 8628233673 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12590 | TX | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lynn Sleep Wellness Solutions | Current | Accepting new patients |
Locations
6190 Lyndon B Johnson Fwy
Ste 900
Dallas, TX 75240
Phone (972) 934-1400
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1639198310",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6190 LYNDON B JOHNSON FWY",
"address_2": "SUITE 900",
"city": "DALLAS",
"state": "TX",
"postal_code": "752406344",
"telephone_number": "972-934-1400",
"fax_number": "972-934-0195"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6190 LYNDON B JOHNSON FWY",
"address_2": "SUITE 900",
"city": "DALLAS",
"state": "TX",
"postal_code": "752406344",
"telephone_number": "972-934-1400",
"fax_number": "972-934-0195"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYNN",
"first_name": "DAVID",
"middle_name": "BROCK",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "TX",
"license": "12590",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "DAVID",
"last_name": "LYNN",
"middle_name": "BROCK",
"prefix": "DR.",
"suffix": "JR.",
"credential": "D.D.S., M.S., P.A.",
"code": "2",
"type": "Professional Name"
}
]
}
Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.