MEDICARE: BRIGHT DENTAL INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	38077	CA

General Provider Information

NPI Number	:	1679796312
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIGHT DENTAL INC

Provider Business Mailing Address
First Line	:	1222 EAST YORBA LINDA BLVD
Second Line	:
City	:	PLACENTA
State	:	CA
Zip	:	92870-3832
Country	:	US
Telephone Number	:	714-528-9558
Fax Number	:	714-528-9538

Provider Business Practice Location Address
First Line	:	1222 EAST YORBA LINDA BLVD
Second Line	:
City	:	PLACENTA
State	:	CA
Zip	:	92870-3832
Country	:	US
Telephone Number	:	714-528-9558
Fax Number	:	714-528-9538

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. CHANG YEN LIN
Credential	:	DDS
Telephone Number	:	714-528-9558

Provider Enumeration Date	:	04/11/2007
Last Update Date	:	08/22/2020

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