SPENCER LIN DMD
NPI 1194255059
Student in an Organized Health Care Education/Training Program in Bronx, NY

Q: What is Spencer Lin's NPI number?

The NPI number for Spencer Lin is 1194255059. It was assigned to this individual provider in the NPPES registry on June 14, 2017.

Q: What is Spencer Lin's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Spencer Lin was last updated on June 14, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 14, 2017PECOS Enrolled

1775 GRAND CONCOURSE FL 6, BRONX, NY 10453(718) 901-8110(718) 901-8162 Get Directions Write a Review

NPPES record last updated: June 14, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Spencer Lin Dmd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SPENCER LIN DMD (NPI 1194255059) is an individual student in an organized health care education/training program in Bronx, New York and active in the NPI registry since June 2017. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1194255059

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameSPENCER LINCredential: DMD

Location Address1775 GRAND CONCOURSE FL 6Bronx, NY 10453-8202

Mailing Address1775 Grand Concourse Fl 6Bronx, NY 10453-8202 · (718) 901-8110 · Fax (718) 901-8162

Phone(718) 901-8110

Fax(718) 901-8162

Sole ProprietorNo

Enumeration DateJune 14, 2017

✔ NPI 1194255059 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

1775 GRAND CONCOURSE FL 6, Bronx, NY 10453

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Spencer Lin Dmd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. LOLADE SIMISOLA OLAYINKA DDS

Student in an Organized Health Care Education/Training Program