Active NPI
Christopher Jin, D.M.D.
- Endodontics
- Rockville, MD
National Provider Identifier
1972927713
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 15913
- Practice address
- 11125 Rockville Pike Ste 103
Rockville, MD 20852-3142 - Phone
- (301) 231-0744
- NPI assigned
- Feb 14, 2014
- 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 |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 15913 | MD | Primary |
Addresses
Primary practice location
11125 Rockville Pike Ste 103
Rockville, MD 20852-3142
Mailing address
11125 Rockville Pike Ste 103
Rockville, MD 20852-3142
Phone (301) 231-0744
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
- 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 |
|---|---|---|---|---|
| I20160219000912 | MD | Order and Referring Only - Other (Physician) | 7911202544 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15913 | MD | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Doctors Weber & Walker, PC | Endodontics | 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.
-
- Endodontics
- Rockville, MD
- NPI 1366652695
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1392336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655164800000",
"number": "1972927713",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11125 ROCKVILLE PIKE STE 103",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208523142",
"telephone_number": "301-231-0744"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11125 ROCKVILLE PIKE STE 103",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208523142",
"telephone_number": "301-231-0744"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JIN",
"first_name": "CHRISTOPHER",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-02-14",
"last_updated": "2022-06-14",
"certification_date": "2022-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "MD",
"license": "15913",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rockville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2022; 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.