Individual provider Active NPI

William K Shin, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Cumming, GA
National Provider Identifier
1346647344
Registry record updated Aug 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DN015403 Issued in GA
Practice address
5520 Castleberry Rd Ste 300
Cumming, GA 30040-8054
Phone
(470) 239-4289
NPI assigned
Nov 19, 2014
Last updated
Aug 22, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DN015403 GA Primary

Addresses

Primary practice location

5520 Castleberry Rd Ste 300
Cumming, GA 30040-8054

Mailing address

5520 Castleberry Rd Ste 300
Cumming, GA 30040-8054

Other practice location 1

5008 Buford Hwy Ste B
Chamblee, GA 30341-3531
Phone (770) 457-3671

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
DN015403GAMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Wacs Oral and Maxillofacial Surgery CurrentSince Jun 6, 2021 Accepting new patients
Woodstock Dentistry, PC Past Accepting new patients

Locations

5008 Buford Hwy
Ste B
Chamblee, GA 30341
Phone (770) 457-3671

5520 Castleberry Rd
Ste 300
Cumming, GA 30040

Organizations & group practices 2

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": "1416355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787356800000",
    "number": "1346647344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5520 CASTLEBERRY RD STE 300",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300408054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5520 CASTLEBERRY RD STE 300",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300408054",
            "telephone_number": "470-239-4289"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5008 Buford Hwy Ste B",
            "address_purpose": "LOCATION",
            "city": "Chamblee",
            "state": "GA",
            "postal_code": "303413531",
            "country_code": "US",
            "telephone_number": "770-457-3671",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIN",
        "first_name": "WILLIAM",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-11-19",
        "last_updated": "2026-08-22",
        "certification_date": "2026-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "GA",
            "license": "DN015403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.