Moo Su Shin, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

37162 Issued in CA

Practice address

7112 Van Nuys Blvd
205
Van Nuys, CA 91405-3086

Phone

(818) 787-9996

Fax

(818) 787-0114

NPI assigned

May 22, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194934620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7112 VAN NUYS BLVD",
            "address_2": "205",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914053086",
            "telephone_number": "818-787-9996",
            "fax_number": "818-787-0114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7112 VAN NUYS BLVD",
            "address_2": "205",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914053086",
            "telephone_number": "818-787-9996",
            "fax_number": "818-787-0114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "MOO SU",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "37162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lilia Sheshukova
• Shield Home Care Inc
• Shield Hospice & Palliative Care, Inc
• Shiffman & Buch MDS Inc
• Chang Sung Shin, DO
• Shining Star Home Health Care, Inc.
• Misak Sarkis Shnorhavorian, D.D.S.
• Emily Shochet
• Shodhan Dental Corp.
• Rasha Sholy, M.A., IMF

• General Practice Dentistry in Van Nuys, CA
• Providers in Van Nuys, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.