Active NPI
Bowman Young Shin, D.M.D.
- Dentist
- Lynnwood, WA
National Provider Identifier
1467527416
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DE0008921
- Practice address
- 19108 33Rd Ave W Ste C
Lynnwood, WA 98036-4728 - Phone
- (425) 774-9571
- Fax
- (425) 774-5727
- NPI assigned
- Nov 22, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DE0008921 | WA | Primary |
Addresses
Primary practice location
19108 33Rd Ave W Ste C
Lynnwood, WA 98036-4728
Mailing address
1030 Big Tree Dr NW
Issaquah, WA 98027-5611
Phone (425) 260-8390
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
| License | State | Type | Specialty |
|---|---|---|---|
| DE0008921 | WA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr. Michael S. Caparas DMD PC | Dentist | Past | Accepting new patients |
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601510400000",
"number": "1467527416",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1030 BIG TREE DR NW",
"city": "ISSAQUAH",
"state": "WA",
"postal_code": "980275611",
"telephone_number": "425-260-8390",
"fax_number": "425-774-5727"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19108 33RD AVE W STE C",
"city": "LYNNWOOD",
"state": "WA",
"postal_code": "980364728",
"telephone_number": "425-774-9571",
"fax_number": "425-774-5727"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIN",
"first_name": "BOWMAN",
"middle_name": "YOUNG",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-22",
"last_updated": "2020-10-01",
"certification_date": "2020-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "DE0008921",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lynnwood, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.