Individual provider Active NPI

James Lin, DMD

  • Dentist
  • Los Gatos, CA
National Provider Identifier
1710369343
Registry record updated Mar 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
100753 Issued in CA
Practice address
14777 Los Gatos Blvd Ste 103
Los Gatos, CA 95032-2059
Phone
(408) 358-2161
NPI assigned
Jun 19, 2015
Last updated
Mar 11, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 100753 CA Primary

Addresses

Primary practice location

14777 Los Gatos Blvd Ste 103
Los Gatos, CA 95032-2059

Mailing address

14777 Los Gatos Blvd Ste 103
Los Gatos, CA 95032-2059

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20150909000126 MI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 2769798628

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
100753CAMDCertified Registered Nurse Anesthetist

NPI Registry JSON

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

{
    "created_epoch": "1434672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646956800000",
    "number": "1710369343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14777 LOS GATOS BLVD STE 103",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950322059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14777 LOS GATOS BLVD STE 103",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950322059",
            "telephone_number": "408-358-2161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIN",
        "first_name": "JAMES",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-19",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "100753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Gatos, CA

Sources for this page

Verify at the official NPI Registry.