Active NPI
Winston Lin, D.D.S.
- Pediatric Dentistry
- Elk Grove, CA
National Provider Identifier
1891006128
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 60196
- Practice address
- 9640 Bruceville Rd
101
Elk Grove, CA 95757-5936 - Phone
- (916) 686-9030
- NPI assigned
- Jul 1, 2010
- 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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 60196 | CA | Primary |
Addresses
Primary practice location
9640 Bruceville Rd
101
Elk Grove, CA 95757-5936
Mailing address
812 Cobble Cove LN
Sacramento, CA 95831-4309
Phone (310) 612-2284
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- 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 |
|---|---|---|---|---|
| I20150811006095 | CA | Order and Referring Only - Dentist | 8820303456 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Johal and Ghazal Dental Corporation | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- General Practice Dentistry
- Elk Grove, CA
- NPI 1114109386
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277942400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1376524800000",
"number": "1891006128",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "812 COBBLE COVE LN",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958314309",
"telephone_number": "310-612-2284"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9640 BRUCEVILLE RD",
"address_2": "101",
"city": "ELK GROVE",
"state": "CA",
"postal_code": "957575936",
"telephone_number": "916-686-9030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIN",
"first_name": "WINSTON",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-07-01",
"last_updated": "2013-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "CA",
"license": "60196",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Elk Grove, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2013; 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.