Active NPI
Yu Chun Shin, DDS
- Dentist
- Los Angeles, CA
National Provider Identifier
1083379812
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 106494
- Practice address
- 903 Crenshaw Blvd Ste 303
Los Angeles, CA 90019-1967 - Phone
- (323) 930-4800
- NPI assigned
- Nov 5, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 106494 | CA | Primary |
Addresses
Primary practice location
903 Crenshaw Blvd Ste 303
Los Angeles, CA 90019-1967
Mailing address
3310 W Adams Blvd Apt 310
Los Angeles, CA 90018-5414
Phone (951) 205-0480
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 106494 | CA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Young Bae Kim D.D.S Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Los Angeles, CA
- NPI 1801215710
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1636070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636070400000",
"number": "1083379812",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3310 W ADAMS BLVD APT 310",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900185414",
"telephone_number": "951-205-0480"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "903 CRENSHAW BLVD STE 303",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900191967",
"telephone_number": "323-930-4800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIN",
"first_name": "YU CHUN",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-11-05",
"last_updated": "2021-11-05",
"certification_date": "2021-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "106494",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.