Eunjung Shim, DMD, MDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

057009 Issued in NJ

Practice address

654 Avenue C Ste 202
Bayonne, NJ 07002-3899

Phone

(201) 436-7777

NPI assigned

Aug 18, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Cozy Dental

  • Dental Clinic/Center
  • Great Neck, NY
  • NPI 1972202497
  NPD Authorized official
• Bay Dental Associates, LLC

  • Pediatric Dentistry
  • Bayonne, NJ
  • NPI 1801338140

  Periodontics

  NPD (past)

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475625600000",
    "number": "1104930056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 MUNSEY RD",
            "city": "EMERSON",
            "state": "NJ",
            "postal_code": "076301513",
            "telephone_number": "201-927-7144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "654 AVENUE C STE 202",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070023899",
            "telephone_number": "201-436-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIM",
        "first_name": "EUNJUNG",
        "credential": "DMD, MDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-18",
        "last_updated": "2016-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02329900",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NJ",
            "license": "057009",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "9363084",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandy Shehata, MA, LAC
• Muhammad Bilal Sheikh, PHARMD
• Ashraf Shenouda
• Magdolin Mishel Samy Saad Shenouda, PT, DPT, PH.D.
• Sara Shi, DO
• Javad Shirvanian, MD
• Shop Fusion, Inc
• David Shor, LCSW
• Mohammed Abdul Aleem Siddiqui
• Amonious Sidrak

• Periodontics in Bayonne, NJ
• Providers in Bayonne, NJ by specialty
• Periodontics in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2016; 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.