SH Shin DMD PC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

23002 Issued in TX

Legal business name

SH SHIN DMD PC

Practice address

2625 Old Denton Rd # 101
Carrollton, TX 75007-5125

Phone

(682) 554-5969

NPI assigned

Dec 2, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Sang Ho Shin

Title

President

Phone

(682) 554-5969

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1259712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259712000000",
    "number": "1053649053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 SILVERWOOD CIR",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760928555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 OLD DENTON RD # 101",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750075125",
            "telephone_number": "682-554-5969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SH SHIN DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-02",
        "last_updated": "2009-12-02",
        "status": "A",
        "authorized_official_last_name": "SHIN",
        "authorized_official_first_name": "SANG",
        "authorized_official_middle_name": "HO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "682-554-5969"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "23002",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "23002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shahriar Setoudeh-Maram, MD
• Roy A Setzenfand, MD
• Adam L Sewell, MD
• Shayla Sewell
• Jamie Seykora, SLP
• Zohra Shad, MD
• Kristin Jane Shaffer, PA
• Dimple Shah Raja
• Alpa Shah, MD
• Anal Shah, PT

• Periodontics in Carrollton, TX
• Providers in Carrollton, TX by specialty
• Periodontics in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.