Individual provider Active NPI

Hyun Shin, DDS

  • Dentist
  • Mount Vernon, NY
National Provider Identifier
1235560822
Registry record updated Aug 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
056982-1 Issued in NY
Practice address
107 W 4TH St
Mount Vernon Neighborhood Health Center
Mount Vernon, NY 10550-4002
Phone
(914) 699-7200
Fax
(914) 699-0837
NPI assigned
Dec 6, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 056982-1 NY Primary

Addresses

Primary practice location

107 W 4TH St
Mount Vernon Neighborhood Health Center
Mount Vernon, NY 10550-4002

Mailing address

107 W 4TH St
Mount Vernon Neighborhood Health Center
Mount Vernon, NY 10550-4002
Phone (914) 699-7200

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
056982-1NYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1386288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407974400000",
    "number": "1235560822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 W 4TH ST",
            "address_2": "MOUNT VERNON NEIGHBORHOOD HEALTH CENTER",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105504002",
            "telephone_number": "914-699-7200",
            "fax_number": "914-699-0837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 W 4TH ST",
            "address_2": "MOUNT VERNON NEIGHBORHOOD HEALTH CENTER",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105504002",
            "telephone_number": "914-699-7200",
            "fax_number": "914-699-0837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "HYUN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-06",
        "last_updated": "2014-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "056982-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 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.