Ivy Fangyu Lin, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

DE60857215 Issued in WA

Practice address

1200 12TH Ave S Ste 401
Seattle, WA 98144-2730

Phone

(206) 548-5850

Fax

(206) 328-4034

NPI assigned

Mar 28, 2017

Reactivated

Nov 13, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Fang Yu Lin Former name

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ilin583305@direct.ochin.org

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.

• Neighborcare Health

  • Federally Qualified Health Center (FQHC)
  • Seattle, WA
  • NPI 1578593562

  WA

  Medicare reassignment NPD
• Neighborcare Health

  • Federally Qualified Health Center (FQHC)
  • Seattle, WA
  • NPI 1073030508
  NPD
• Neighborcare Health

  • Federally Qualified Health Center (FQHC)
  • Seattle, WA
  • NPI 1104161496
  NPD
• Neighborcare Health

  • Federally Qualified Health Center (FQHC)
  • Seattle, WA
  • NPI 1275187429
  NPD
• Neighborcare Health

  • Federally Qualified Health Center (FQHC)
  • Seattle, WA
  • NPI 1275567539
  NPD
• Neighborcare Health

  • Federally Qualified Health Center (FQHC)
  • Seattle, WA
  • NPI 1982052874

  Dentist

  NPD

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

{
    "created_epoch": "1490659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655683200000",
    "number": "1982136289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 12TH AVE S STE 901",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981442712",
            "telephone_number": "206-548-3058",
            "fax_number": "206-262-0859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 12TH AVE S STE 401",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981442730",
            "telephone_number": "206-548-5850",
            "fax_number": "206-328-4034"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "23320 Highway 99",
            "address_purpose": "LOCATION",
            "city": "Edmonds",
            "state": "WA",
            "postal_code": "98026",
            "country_code": "US",
            "telephone_number": "425-640-5500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIN",
        "first_name": "IVY",
        "middle_name": "FANGYU",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-28",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-20",
        "deactivation_date": "2017-10-30",
        "reactivation_date": "2017-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60857215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FANG YU",
            "last_name": "LIN",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Elizabeth H Lin, M.D.
• Eugene C Lin, MD
• Hannah May Lin, MD
• Hueylie Lin, MD
• Isaiah Lin, PSY.D.
• James L Lin, PHARM.D
• James S Lin, MD
• Jau Wade Lin
• Jed Markus Lin, MSW, LICSW
• Jenn-Yih Lin, DDS

• All providers in Seattle, WA
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.

Verify at the official NPI Registry.