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General NPI Number Information
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NPI Number | 1982344644
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Entity Type | Individual
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Provider Name | JESSICA TZUYU LIN DMD
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Gender | Female
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Dates
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Enumeration Date | 03/30/2022
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Last Update Date | 07/31/2025
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Provider Practice Location Address
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Address Line | 12265 LA MIRADA BLVD
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City | LA MIRADA
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State | CA
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Zip | 90638-1329
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Country | US
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Telephone | 562-944-8408
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Fax |
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Provider Business Mailing Address
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Address Line | 3943 IRVINE BLVD # 99
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City | IRVINE
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State | CA
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Zip | 92602-2400
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Country | US
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Telephone | 562-556-2368
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DDS110817
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License Number State | CA
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