NPIMap

Organization Active NPI

Irene Shin DDS of Maryland LLC

  • Dentist
  • Fort Washington, MD
National Provider Identifier
1487522553
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
IRENE SHIN DDS OF MARYLAND LLC
Practice address
12786 Old Fort Rd
Fort Washington, MD 20744-2871
Phone
(301) 292-0900
NPI assigned
Oct 29, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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

Authorized official

Name
Dr. Irene Shin, DDSNPI 1013561604
Title
Dentist/Owner
Phone
(301) 292-0900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

12786 Old Fort Rd
Fort Washington, MD 20744-2871

Mailing address

12786 Old Fort Rd
Fort Washington, MD 20744-2871
Phone (301) 292-0900

National Provider Directory

National Provider Directory

Locations

12786 Old Fort Rd
Ft Washington, MD 20744
Phone (301) 292-0900

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1761696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761696000000",
    "number": "1487522553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12786 OLD FORT RD",
            "city": "FORT WASHINGTON",
            "state": "MD",
            "postal_code": "207442871",
            "telephone_number": "301-292-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12786 OLD FORT RD",
            "city": "FORT WASHINGTON",
            "state": "MD",
            "postal_code": "207442871",
            "telephone_number": "301-292-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IRENE SHIN DDS OF MARYLAND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-29",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A",
        "authorized_official_last_name": "SHIN",
        "authorized_official_first_name": "IRENE",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "301-292-0900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Washington, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2025; 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.