Eui Sik Shin, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401417775 Issued in VA

Practice address

1900 N Broadway
Baltimore, MD 21213-1437

Phone

(443) 241-2516

NPI assigned

Jul 14, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Shines LLC

  • Dental Clinic/Center
  • Ellicott City, MD
  • NPI 1649928649

  Dentist

  NPD
• East 22ND Street Dental, P.C.

  • General Practice Dentistry
  • Tucson, AZ
  • NPI 1396832994
  NPD (past)
• Tremont Road Dental Super, P.C.

  • General Practice Dentistry
  • Falls Church, VA
  • NPI 1366539959
  NPD (past)

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

{
    "created_epoch": "1405296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657152000000",
    "number": "1104233998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11045 NASHVILLE CT",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210422485",
            "telephone_number": "312-505-1629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 N BROADWAY",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212131437",
            "telephone_number": "443-241-2516"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2316 S Zapata Hwy Ste 190",
            "address_purpose": "LOCATION",
            "city": "Laredo",
            "state": "TX",
            "postal_code": "780466590",
            "country_code": "US",
            "telephone_number": "956-284-0570",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIN",
        "first_name": "EUI SIK",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-14",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "8982",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "30901",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "8982",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401417775",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "16102",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1144651",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "349710901",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "927285",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Megan Eileen Shimkaveg, M.D.
• Eleanor Edith Shimkin-Sorock, M.D.
• Alice Shin, M.D.
• Anthony Shin, LCPC
• Baekhyo Shin, M.D.
• Eun Ji Shin, M.D.
• Hyesung Shin
• NA Shin
• Ronald Shin, D.O.
• Winnifer J Shin, PHARMD

• General Practice Dentistry in Baltimore, MD
• Providers in Baltimore, MD by specialty
• General Practice Dentistry in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2022; 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.