Active NPI
Edward Y Lin, D.D.S.
- Orthodontics and Dentofacial Orthopedics Dentistry
- Green Bay, WI
National Provider Identifier
1962737338
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 5150015
- Practice address
- 2821 S. Webster Ave.
Orthodontic Specialists of Green Bay
Green Bay, WI 54301 - Phone
- (920) 336-2299
- NPI assigned
- Oct 2, 2009
- 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 |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 5150015 | WI | Primary |
Addresses
Primary practice location
2821 S. Webster Ave.
Orthodontic Specialists of Green Bay
Green Bay, WI 54301
Mailing address
2821 S. Webster Ave.
Orthodontic Specialists of Green Bay
Green Bay, WI 54301
Phone (920) 336-2299
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Oct 1, 2013 through Oct 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5150015 | WI | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Dermatology Group LTD | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Orthodontics and Dentofacial Orthopedics Dentistry
- De Pere, WI
- NPI 1376618207
-
- Dermatology Physician
- Howard, WI
- NPI 1235480112
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1254441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1385078400000",
"number": "1962737338",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2821 S. WEBSTER AVE.",
"address_2": "ORTHODONTIC SPECIALISTS OF GREEN BAY",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "54301",
"telephone_number": "920-336-2299",
"fax_number": "920-336-2847"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2821 S. WEBSTER AVE.",
"address_2": "ORTHODONTIC SPECIALISTS OF GREEN BAY",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "54301",
"telephone_number": "920-336-2299"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIN",
"first_name": "EDWARD",
"middle_name": "Y",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-10-02",
"last_updated": "2013-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "WI",
"license": "5150015",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Green Bay, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.