Healthcare Provider Details

I. General information

NPI: 1255840377
Provider Name (Legal Business Name): ALBERT LIN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2017
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1070 E RAY RD STE 7
CHANDLER AZ
85225
US

IV. Provider business mailing address

1689 W DAWN DR
TEMPE AZ
85284-1213
US

V. Phone/Fax

Practice location:
  • Phone: 480-792-6880
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number9845
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: