Joseph Hyung-Suk Shim

Primary specialty

DentistTaxonomy code 122300000X

License

105132 Issued in CA

Practice address

470 Orange St
Redlands, CA 92374-3240

Phone

(909) 793-4585

NPI assigned

Aug 7, 2020

Last updated

Oct 26, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1596758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1518577055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24838A TULIP AVE",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543406",
            "telephone_number": "678-994-1705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 ORANGE ST",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923743240",
            "telephone_number": "909-793-4585"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14515 Mojave Dr",
            "address_purpose": "LOCATION",
            "city": "Victorville",
            "state": "CA",
            "postal_code": "923946762",
            "country_code": "US",
            "telephone_number": "760-241-8090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIM",
        "first_name": "JOSEPH",
        "middle_name": "HYUNG-SUK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-07",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "105132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Slade Stewart Shepherd, DDS
• Venice Amelia Sherman
• Carol Sherwood
• Yong-Han Shi, DPM
• Ronald Douglas Shiell, M.D.
• Meighan Shin, RN, BSN, CLC
• Michelle Shin, DDS, MSD
• Stanford Lee Shin
• Sunhae Shin, RDHAP
• Yohan Shin, D.O.

• Dentist in Redlands, CA
• Providers in Redlands, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.

Verify at the official NPI Registry.