Provider Demographics
NPI:1124078126
Name:LIN, WEN- PIN (DDS)
Entity type:Individual
Prefix:DR
First Name:WEN- PIN
Middle Name:
Last Name:LIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1516 BRADBURY RD
Mailing Address - Street 2:
Mailing Address - City:SAN MARINO
Mailing Address - State:CA
Mailing Address - Zip Code:91108-2727
Mailing Address - Country:US
Mailing Address - Phone:626-919-0415
Mailing Address - Fax:626-919-0515
Practice Address - Street 1:1414 S. AZUSA AVE
Practice Address - Street 2:SUITE #B16
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91791
Practice Address - Country:US
Practice Address - Phone:626-919-0415
Practice Address - Fax:626-919-0515
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA494581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice