Organization Active NPI

Sunshine Oral Surgery II, P.a.

Doing business as Four Corners Oral Surgery & Dental Implant Center

  • Oral and Maxillofacial Surgery (Dentist)
  • Clermont, FL
National Provider Identifier
1336006782
Registry record updated Jan 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
SUNSHINE ORAL SURGERY II, P.A.
Doing business as
Four Corners Oral Surgery & Dental Implant Center
Practice address
17075 Cagan Ridge Blvd Ste 103
Clermont, FL 34714-9619
Phone
(516) 376-8471
NPI assigned
Jan 7, 2026
Last updated
Jan 7, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2026

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

Authorized official

Name
Shin Kim, DDS
Title
Owner
Phone
(516) 376-8471

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X NU Primary

Addresses

Primary practice location

17075 Cagan Ridge Blvd Ste 103
Clermont, FL 34714-9619

Mailing address

100 S Eola Dr # P219
Orlando, FL 32801-2888
Phone (516) 376-8471

Other names 1

  • Four Corners Oral Surgery & Dental Implant Center Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1767744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767744000000",
    "number": "1336006782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 S EOLA DR # P219",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328012888",
            "telephone_number": "516-376-8471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17075 CAGAN RIDGE BLVD STE 103",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347149619",
            "telephone_number": "516-376-8471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNSHINE ORAL SURGERY II, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-07",
        "last_updated": "2026-01-07",
        "certification_date": "2026-01-07",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "SHIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-376-8471",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Four Corners Oral Surgery & Dental Implant Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clermont, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 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.