Shine Homes LLC

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

Legal business name

SHINE HOMES LLC

Practice address

802 Dahlia St NW
Washington, DC 20012-2308

Phone

(240) 416-7947

Fax

(301) 861-4109

NPI assigned

Oct 4, 2008

Organization subpart

No

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

Authorized official

Name

Adeshina John Adewale

Title

President

Phone

(240) 416-7947

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1223078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438041600000",
    "number": "1396996781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 DAHLIA ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200122308",
            "telephone_number": "240-416-7947",
            "fax_number": "301-861-4109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 DAHLIA ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200122308",
            "telephone_number": "240-416-7947",
            "fax_number": "301-861-4109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHINE HOMES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-04",
        "last_updated": "2015-07-28",
        "status": "A",
        "authorized_official_last_name": "ADEWALE",
        "authorized_official_first_name": "ADESHINA",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "240-416-7947"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Shin, DMD
• Young Shin
• Judy Elizabeth Shincarick, OTR
• Arthur Shinder, DDS
• Gennady Shinder
• Shining Stars Montessori Academy Public Charter School
• Shiningstars Pediatric Dentistry PC
• Shiningstars Pediatric Dentistry PC
• James Derrick Shird
• Ethan Matthew Shirer

• Preferred Provider Organization in Washington, DC
• Providers in Washington, DC by specialty
• Preferred Provider Organization in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2015; 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.