NPIMap

Organization Active NPI

Shin Prosthodontics LLC

  • Prosthodontics
  • North Bethesda, MD
National Provider Identifier
1255098620
Registry record updated Sep 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
Legal business name
SHIN PROSTHODONTICS LLC
Practice address
5904 Hubbard Dr
North Bethesda, MD 20852-4823
Phone
(301) 377-8306
Fax
(240) 387-6945
NPI assigned
Nov 20, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2026

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

Authorized official

Name
Dr. Dongjin Shin, DMDNPI 1235532292
Title
Owner
Phone
(301) 377-8306

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223E0200X
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X
ProsthodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0700X Primary
Dental Clinic/Center 261QD0000X

Addresses

Primary practice location

5904 Hubbard Dr
North Bethesda, MD 20852-4823

Mailing address

5904 Hubbard Dr
North Bethesda, MD 20852-4823
Phone (301) 377-8306

Other names 3

  • PEDG Rockville MD LLC Former legal business name
  • PEDG Other name
  • Prostho Endo Dental Group Other name

National Provider Directory

National Provider Directory

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": "1637366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788998400000",
    "number": "1255098620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5904 HUBBARD DR",
            "city": "NORTH BETHESDA",
            "state": "MD",
            "postal_code": "208524823",
            "telephone_number": "301-377-8306",
            "fax_number": "240-387-6945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5904 HUBBARD DR",
            "city": "NORTH BETHESDA",
            "state": "MD",
            "postal_code": "208524823",
            "telephone_number": "301-377-8306",
            "fax_number": "240-387-6945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHIN PROSTHODONTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-20",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A",
        "authorized_official_last_name": "SHIN",
        "authorized_official_first_name": "DONGJIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-377-8306",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PEDG Rockville MD LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "PEDG",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Prostho Endo Dental Group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in North Bethesda, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; 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.