NPIMap

Organization Active NPI

Hyun Shin, DDS., Inc.

Doing business as Dr. Shin's Dental Office

  • General Practice Dentistry
  • Victorville, CA
National Provider Identifier
1174925770
Registry record updated Sep 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
44361 Issued in CA
Legal business name
HYUN SHIN, DDS., INC.
Doing business as
Dr. Shin's Dental Office
Practice address
17100 Bear Valley Rd
Suite N
Victorville, CA 92395-5853
Phone
(760) 245-7083
NPI assigned
Sep 25, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2014

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

Authorized official

Name
Dr. Hyun Joon Shin, DDSNPI 1518039510
Title
Owner
Phone
(760) 245-7083

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 44361 CA Primary

Addresses

Primary practice location

17100 Bear Valley Rd
Suite N
Victorville, CA 92395-5853

Mailing address

17100 Bear Valley Rd
Suite N
Victorville, CA 92395-5853
Phone (760) 245-7083

Other identifiers 1

IdentifierTypeStateIssuer
B44361-01OtherCADENTI-CAL

Other names 1

  • Dr. Shin's Dental Office Doing business as

National Provider Directory

National Provider Directory

Locations

17100 Bear Valley Rd
Ste N
Victorville, CA 92395
Phone (760) 245-7083

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1411603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411603200000",
    "number": "1174925770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17100 BEAR VALLEY RD",
            "address_2": "SUITE N",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923955853",
            "telephone_number": "760-245-7083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17100 BEAR VALLEY RD",
            "address_2": "SUITE N",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923955853",
            "telephone_number": "760-245-7083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HYUN SHIN, DDS., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-25",
        "last_updated": "2014-09-25",
        "status": "A",
        "authorized_official_last_name": "SHIN",
        "authorized_official_first_name": "HYUN JOON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "760-245-7083",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "44361",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTI-CAL",
            "identifier": "B44361-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Shin's Dental Office",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Victorville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2014; 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.