Active NPI
Soyoung Shin, DMD
- Dentist
- Greenbelt, MD
National Provider Identifier
1275166753
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 17151
- Practice address
- 7500 Hanover Pkwy Ste 106
Greenbelt, MD 20770-2011 - Phone
- (301) 474-9100
- NPI assigned
- Feb 13, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 17151 | MD | Primary |
Addresses
Primary practice location
7500 Hanover Pkwy Ste 106
Greenbelt, MD 20770-2011
Mailing address
7001 Arlington Rd Apt 407
Bethesda, MD 20814-5489
Phone (510) 520-6386
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
| License | State | Type | Specialty |
|---|---|---|---|
| 17151 | MD | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1581552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581552000000",
"number": "1275166753",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7001 ARLINGTON RD APT 407",
"city": "BETHESDA",
"state": "MD",
"postal_code": "208145489",
"telephone_number": "510-520-6386"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7500 HANOVER PKWY STE 106",
"city": "GREENBELT",
"state": "MD",
"postal_code": "207702011",
"telephone_number": "301-474-9100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIN",
"first_name": "SOYOUNG",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-02-13",
"last_updated": "2020-02-13",
"certification_date": "2020-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist",
"state": "MD",
"license": "17151",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenbelt, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 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.