Active NPI
Douglas C Lin, D.D.S.
- General Practice Dentistry
- Hercules, CA
National Provider Identifier
1861588691
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 44010
- Practice address
- 500 Alfred Nobel Dr
Suite 130
Hercules, CA 94547-1838 - Phone
- (510) 741-1777
- Fax
- (510) 741-7401
- NPI assigned
- Oct 5, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 44010 | CA | Primary |
Addresses
Primary practice location
500 Alfred Nobel Dr
Suite 130
Hercules, CA 94547-1838
Mailing address
500 Alfred Nobel Dr
Suite 130
Hercules, CA 94547-1838
Phone (510) 741-1777
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 770587444 | Other | CA | TAX ID |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 44010 | CA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hercules Dental Care in Fremont | Past | Accepting new patients | |
| Douglas Lin, DDS, Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Dentist
- Fremont, CA
- NPI 1942774989
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1861588691",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 ALFRED NOBEL DR",
"address_2": "SUITE 130",
"city": "HERCULES",
"state": "CA",
"postal_code": "945471838",
"telephone_number": "510-741-1777",
"fax_number": "510-741-7401"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 ALFRED NOBEL DR",
"address_2": "SUITE 130",
"city": "HERCULES",
"state": "CA",
"postal_code": "945471838",
"telephone_number": "510-741-1777",
"fax_number": "510-741-7401"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIN",
"first_name": "DOUGLAS",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "44010",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "770587444",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hercules, CA
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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.