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General NPI Number Information
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NPI Number | 1336768613
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Entity Type | Individual
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Provider Name | GREGORY LIN DDS
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Gender | Male
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Dates
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Enumeration Date | 04/15/2020
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Last Update Date | 10/07/2024
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Provider Practice Location Address
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Address Line | 6201 ANTIOCH ST STE 102
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City | OAKLAND
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State | CA
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Zip | 94611-2945
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Country | US
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Telephone | 510-390-8833
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Fax |
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Provider Business Mailing Address
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Address Line | 5 EGRET CT
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City | ALAMEDA
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State | CA
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Zip | 94501-6438
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Country | US
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Telephone | 510-688-0674
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DDS106633
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License Number State | CA
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