Provider Demographics
NPI:1871778373
Name:LIN, SEAN (DDS)
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:LIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:947 S ANAHEIM BLVD
Mailing Address - Street 2:STE 260
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92805-5582
Mailing Address - Country:US
Mailing Address - Phone:714-808-0288
Mailing Address - Fax:714-808-0788
Practice Address - Street 1:947 S ANAHEIM BLVD
Practice Address - Street 2:STE 260
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92805-5582
Practice Address - Country:US
Practice Address - Phone:714-808-0288
Practice Address - Fax:714-808-0788
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-02
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA453851223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics