Provider Demographics
NPI:1174648406
Name:LINN, KIRK ALLEN (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:KIRK
Middle Name:ALLEN
Last Name:LINN
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13203 HADLEY ST STE 100
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90601-4537
Mailing Address - Country:US
Mailing Address - Phone:562-907-2101
Mailing Address - Fax:562-907-2104
Practice Address - Street 1:13203 HADLEY ST STE 100
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90601-4537
Practice Address - Country:US
Practice Address - Phone:562-907-2101
Practice Address - Fax:562-907-2104
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA361711223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics