Individual provider Active NPI

Aristo Shyn, DMD

  • Dentist
  • Norcross, GA
National Provider Identifier
1306100060
Registry record updated Dec 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN014515 Issued in GA
Practice address
6270 Smithpointe Dr
Norcross, GA 30092-2754
Phone
(770) 448-1977
Fax
(770) 613-0448
NPI assigned
Jun 27, 2012
Last updated
Dec 6, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN014515 GA Primary

Addresses

Primary practice location

6270 Smithpointe Dr
Norcross, GA 30092-2754

Mailing address

5635 Peachtree Pkwy Ste 240
Norcross, GA 30092-2823
Phone (770) 448-1977

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
DN014515GAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Link Dental Care, LLC Current Accepting new patients

Locations

5635 Peachtree Pkwy
Ste 240
Norcross, GA 30092
Phone (770) 448-1977

6270 Smithpointe Dr
Norcross, GA 30092
Phone (770) 448-1977

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1340755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1306100060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5635 PEACHTREE PKWY STE 240",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300922823",
            "telephone_number": "770-448-1977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6270 SMITHPOINTE DR",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300922754",
            "telephone_number": "770-448-1977",
            "fax_number": "770-613-0448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHYN",
        "first_name": "ARISTO",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-27",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN014515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norcross, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2021; 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.