Individual provider Active NPI

Andrew Hongyu Lin, DDS

  • Dentist
  • Artesia, CA
National Provider Identifier
1750906624
Registry record updated Sep 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
107579 Issued in CA
Practice address
11635 South St
Artesia, CA 90701-6628
Phone
(562) 924-4401
NPI assigned
Jun 16, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dentist 122300000X 107579 CA Primary

Addresses

Primary practice location

11635 South St
Artesia, CA 90701-6628

Mailing address

11635 South St
Artesia, CA 90701-6628
Phone (562) 924-4401

Other practice location 1

Stony Brook Medicine Hsc Level 4 Room 176
Stony Brook, NY 11794-8430
Phone (631) 638-8517

Other practice location 2

714 Tiverton Ave
Los Angeles, CA 90095-8361
Phone (626) 716-7898

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
107579CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1592265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1750906624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11635 SOUTH ST",
            "city": "ARTESIA",
            "state": "CA",
            "postal_code": "907016628",
            "telephone_number": "562-924-4401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11635 SOUTH ST",
            "city": "ARTESIA",
            "state": "CA",
            "postal_code": "907016628",
            "telephone_number": "562-924-4401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Stony Brook Medicine Hsc Level 4 Room 176",
            "address_purpose": "LOCATION",
            "city": "Stony Brook",
            "state": "NY",
            "postal_code": "117948430",
            "country_code": "US",
            "telephone_number": "631-638-8517",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "714 Tiverton Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900958361",
            "country_code": "US",
            "telephone_number": "626-716-7898",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIN",
        "first_name": "ANDREW HONGYU",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-16",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "107579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Artesia, CA

Sources for this page

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