NPIMap

Organization Active NPI

Hercules Dental Care in Fremont

  • Dentist
  • Fremont, CA
National Provider Identifier
1942774989
Registry record updated Jan 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
HERCULES DENTAL CARE IN FREMONT
Practice address
556 Mowry Ave Ste 203
Fremont, CA 94536-4186
Phone
(510) 791-0600
NPI assigned
Jan 13, 2019
Organization subpart
Yes
Parent organization
DOUGLAS LIN DDS INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 13, 2019

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

Authorized official

Name
Dr. Douglas C Lin, DDSNPI 1861588691
Title
President
Phone
(510) 741-1777

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

556 Mowry Ave Ste 203
Fremont, CA 94536-4186

Mailing address

500 Alfred Nobel Dr Ste 130
Hercules, CA 94547-1839
Phone (510) 741-1777

Other identifiers 1

IdentifierTypeStateIssuer
1689904476MedicaidCA

Other names 1

  • Hercules Dental Care in Fremont Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Douglas Lin DDS Inc3 organizations share this tax ID, including this one
Part of
Douglas Lin DDS Inc

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

556 Mowry Ave
Ste 203
Fremont, CA 94536
Phone (510) 791-0600

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1547337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547337600000",
    "number": "1942774989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 ALFRED NOBEL DR STE 130",
            "city": "HERCULES",
            "state": "CA",
            "postal_code": "945471839",
            "telephone_number": "510-741-1777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "556 MOWRY AVE STE 203",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945364186",
            "telephone_number": "510-791-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERCULES DENTAL CARE IN FREMONT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DOUGLAS LIN DDS INC",
        "enumeration_date": "2019-01-13",
        "last_updated": "2019-01-13",
        "status": "A",
        "authorized_official_last_name": "LIN",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "510-741-1777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689904476",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hercules Dental Care in Fremont",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2019; 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.