NPIMap

Organization Active NPI

Hyun J. Shin,

Doing business as Towngate Family Dental

  • General Practice Dentistry
  • Moreno Valley, CA
National Provider Identifier
1275865222
Registry record updated Feb 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
44361 Issued in CA
Legal business name
HYUN J. SHIN,
Doing business as
Towngate Family Dental
Practice address
12625 Frederick St
F-4
Moreno Valley, CA 92553-5216
Phone
(951) 697-7750
NPI assigned
Feb 2, 2010
Last updated
Feb 2, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2010

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

Authorized official

Name
Dr. Hyun Joon Shin, DDS
Title
Ceo
Phone
(951) 697-7750

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 44361 CA Primary

Addresses

Primary practice location

12625 Frederick St
F-4
Moreno Valley, CA 92553-5216

Mailing address

12625 Frederick St
F-4
Moreno Valley, CA 92553-5216
Phone (951) 697-7750

Other names 1

  • Towngate Family Dental Doing business as

National Provider Directory

National Provider Directory

Locations

12625 Frederick St
Ste F4
Moreno Valley, CA 92553
Phone (951) 697-7750

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1265068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265068800000",
    "number": "1275865222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12625 FREDERICK ST",
            "address_2": "F-4",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925535216",
            "telephone_number": "951-697-7750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12625 FREDERICK ST",
            "address_2": "F-4",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925535216",
            "telephone_number": "951-697-7750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HYUN J. SHIN,",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-02",
        "last_updated": "2010-02-02",
        "status": "A",
        "authorized_official_last_name": "SHIN",
        "authorized_official_first_name": "HYUN JOON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "951-697-7750",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "44361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Towngate Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Moreno Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2010; 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.