MEDICARE: MR. CHANG CHYI LIN DDS

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	1223G0001X	General Practice Dentistry	39893	NY

General Provider Information

NPI Number	:	1033297585
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHANG CHYI LIN DDS

Provider Business Mailing Address
First Line	:	1303 RICHMOND AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-1562
Country	:	US
Telephone Number	:	718-983-7559
Fax Number	:	718-984-5926

Provider Business Practice Location Address
First Line	:	1303 RICHMOND AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-1562
Country	:	US
Telephone Number	:	718-983-7559
Fax Number	:	718-984-5926

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	07/08/2007

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