Provider Demographics
NPI:1104046549
Name:GARY C. LIN D.M.D. INC.
Entity type:Organization
Organization Name:GARY C. LIN D.M.D. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:C
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:949-857-8898
Mailing Address - Street 1:4482 BARRANCA PKWY STE 170
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-1707
Mailing Address - Country:US
Mailing Address - Phone:949-857-8898
Mailing Address - Fax:949-857-8890
Practice Address - Street 1:4482 BARRANCA PKWY
Practice Address - Street 2:STE 170
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-4732
Practice Address - Country:US
Practice Address - Phone:949-857-8898
Practice Address - Fax:949-857-8890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA449221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty