JUSTIN TIN DDS DENTAL GROUP A PROFESSIONAL CORPORATION
NPI 1649900622
Dentist in San Francisco, CA

Q: What is Justin Tin Dds Dental Group A Professional Corporation's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Active since June 13, 2022

1636 NORIEGA ST, SAN FRANCISCO, CA 94122(628) 628-1636 Get Directions Write a Review

NPPES record last updated: June 13, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

On this page

About Justin Tin Dds Dental Group A Professional Corporation NPPES

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

JUSTIN TIN DDS DENTAL GROUP A PROFESSIONAL CORPORATION (NPI 1649900622), doing business as Stannum Dental Group, is a healthcare organization registered as a dentist in San Francisco, California and active in the NPI registry since June 2022. The organization lists Justin Tin, Owner, as its authorized official.

NPPES Registry Identity

NPI1649900622

Entity TypeOrganization

Primary Taxonomy122300000X

Legal Business NameJUSTIN TIN DDS DENTAL GROUP A PROFESSIONAL CORPORATION

Location Address1636 NORIEGA STSan Francisco, CA 94122-4306

Mailing Address1636 Noriega StSan Francisco, CA 94122-4306 · (628) 628-1636

Phone(628) 628-1636

Organization SubpartNo

Authorized OfficialJustin TinOwner · (415) 218-3866

Enumeration DateJune 13, 2022

NPPES CertifiedMay 25, 2022

✔ NPI 1649900622 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

1636 NORIEGA ST, San Francisco, CA 94122

Open in Google Maps ↗

Other Names 1

Doing Business AsStannum Dental Group

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Justin Tin Dds Dental Group A Professional Corporation is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Justin Tin DDS Dental Group A Professional Corporation, which bills Medicare for the services this clinician delivers.

Clinician (1)

Justin Tin, DDS

Dentist

NPI 1124233663

2817 SAN BRUNO AVE
San Francisco, CA 94134

(415) 656-2868

✔ PECOS4.7 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Justin Tin Dds Dental Group A Professional Corporation's NPI number?

The NPI number for Justin Tin Dds Dental Group A Professional Corporation is 1649900622. It was assigned to this organization in the NPPES registry on June 13, 2022. The provider is doing business as stannum dental group.

Where is Justin Tin Dds Dental Group A Professional Corporation located?

Justin Tin Dds Dental Group A Professional Corporation is located at 1636 Noriega St, San Francisco, CA 94122. The listed phone number is (628) 628-1636.

What is Justin Tin Dds Dental Group A Professional Corporation's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Justin Tin Dds Dental Group A Professional Corporation enrolled in Medicare?

Yes. Justin Tin Dds Dental Group A Professional Corporation is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Justin Tin Dds Dental Group A Professional Corporation?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Dentist) reassigns their Medicare billing to Justin Tin Dds Dental Group A Professional Corporation. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Justin Tin Dds Dental Group A Professional Corporation was last updated on June 13, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.