Provider Demographics
NPI:1487084752
Name:LIN, CHEN-KAI (DDS)
Entity type:Individual
Prefix:
First Name:CHEN-KAI
Middle Name:
Last Name:LIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:CHEN-KAI
Other - Middle Name:CLARENCE
Other - Last Name:LIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:165 W MAGNA VISTA AVE
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007-4029
Mailing Address - Country:US
Mailing Address - Phone:626-353-7615
Mailing Address - Fax:
Practice Address - Street 1:165 W MAGNA VISTA AVE
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-4029
Practice Address - Country:US
Practice Address - Phone:626-353-7615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-22
Last Update Date:2013-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA627741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice