Individual provider Active NPI

Chris Shin, DDS

  • Dentist
  • Abilene, TX
National Provider Identifier
1225648405
Registry record updated Aug 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
36477 Issued in TX
Practice address
602 Hickory St Ste B
Abilene, TX 79601-5044
Phone
(325) 200-0925
NPI assigned
Aug 3, 2020
Last updated
Aug 3, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 36477 TX Primary

Addresses

Primary practice location

602 Hickory St Ste B
Abilene, TX 79601-5044

Mailing address

6310 Saddlebrook Way
Irving, TX 75039-1237
Phone (469) 279-8920

Other practice location 1

4102 Buffalo Gap Rd Ste F
Abilene, TX 79605-7243
Phone (325) 200-0866

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

LicenseStateTypeSpecialty
36477TXMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1596412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596412800000",
    "number": "1225648405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6310 SADDLEBROOK WAY",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750391237",
            "telephone_number": "469-279-8920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 HICKORY ST STE B",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796015044",
            "telephone_number": "325-200-0925"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4102 Buffalo Gap Rd Ste F",
            "address_purpose": "LOCATION",
            "city": "Abilene",
            "state": "TX",
            "postal_code": "796057243",
            "country_code": "US",
            "telephone_number": "325-200-0866",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIN",
        "first_name": "CHRIS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-03",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "36477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Abilene, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2020; 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.