Elisha Lin

Primary specialty

DentistTaxonomy code 122300000X

License

107964 Issued in CA

Practice address

255 S Grand Ave Ste 204
Los Angeles, CA 90012-3035

Phone

(213) 863-9464

NPI assigned

Aug 18, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1692316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692316800000",
    "number": "1891579173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "332 W PEBBLE BEACH LN",
            "city": "AZUSA",
            "state": "CA",
            "postal_code": "917021440",
            "telephone_number": "808-392-1646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 S GRAND AVE STE 204",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900123035",
            "telephone_number": "213-863-9464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIN",
        "first_name": "ELISHA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-18",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "107964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cindy Lin, PHARM.D.
• Corey Lin, PT, DPT
• Deanna Sharon Lin, MSW TRAINEE
• Derrick Lin
• Edward Lin, MD
• Emily Lin
• Eric Lin
• Erina May Lin, MD
• Ethan Win Thein Lin, MD
• Eugene Lin, MD

• Dentist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2023; 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.