Individual provider Active NPI

Evelyn Rachel Shine-Franco

  • Dentist
  • Brooklyn, NY
National Provider Identifier
1487949228
Registry record updated Aug 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
390200000X Issued in NY
Practice address
4802 10TH Avenue
Brooklyn, NY 11219
Phone
(718) 283-6000
NPI assigned
Jun 9, 2011
Last updated
Aug 8, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 390200000X NY Primary

Addresses

Primary practice location

4802 10TH Avenue
Brooklyn, NY 11219

Mailing address

4802 Tenth Avenue
Maimonides Medical Center
Brooklyn, NY 11219

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
390200000XNYMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
E Shine DDS PC Dentist PastSince Jul 28, 2019 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, 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": "1307577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375920000000",
    "number": "1487949228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4802 TENTH AVENUE",
            "address_2": "MAIMONIDES MEDICAL CENTER",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4802 10TH AVENUE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11219",
            "telephone_number": "718-283-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHINE-FRANCO",
        "first_name": "EVELYN",
        "middle_name": "RACHEL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-09",
        "last_updated": "2013-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "390200000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2013; 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.