Active NPI
Shi Yin, DDS, MS
- Periodontics
- San Bernardino, CA
National Provider Identifier
1346935194
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 306
- Practice address
- 159 W Hospitality LN
San Bernardino, CA 92408-3348 - Phone
- (909) 558-4960
- NPI assigned
- Apr 7, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 0401417843 | VA | |
| Periodontics | 1223P0300X | 306 | CA | Primary |
Addresses
Primary practice location
159 W Hospitality LN
San Bernardino, CA 92408-3348
Mailing address
26000 W Lugonia Ave Apt 4424
Redlands, CA 92374-5111
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 306 | CA | MD | Periodontist |
| 0401417843 | VA | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1680825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1680825600000",
"number": "1346935194",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26000 W LUGONIA AVE APT 4424",
"city": "REDLANDS",
"state": "CA",
"postal_code": "923745111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "159 W HOSPITALITY LN",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924083348",
"telephone_number": "909-558-4960"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YIN",
"first_name": "SHI",
"credential": "DDS, MS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-04-07",
"last_updated": "2023-04-07",
"certification_date": "2023-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "VA",
"license": "0401417843",
"primary": false
},
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "CA",
"license": "306",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Bernardino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.