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Provider Information for 1730347550


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Dr. HSUNG LIN DMD


Sex: Female

NPI: 1730347550
Last Updated: 2021-05-10
Certification Date: 2021-05-10

Details

NameValue
NPI1730347550
Enumeration Date2008-05-29
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 263 FARMINGTON AVE
DENTAL ACADEMIC AFFAIRS
FARMINGTON, CT 06030-3905
United States

Phone: 860-679-2207 | Fax:860-679-1899
 
Primary Practice Address 1 ROYCE CIR
SUITE 108
STORRS, CT 06268-2260
United States

Phone: 860-487-9330 | Fax:860-487-9360
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Direct Messaging Address
hlin11739@uconn.direct.edu
1 Royce Cir
Storrs, CT 06268-2260
United States
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDCT004011136
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 122300000X - Dentist CT009904
Yes 1223G0001X - Dentist - General PracticeCT009904