Jae Wook Shin, D.M.D. P.C.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

JAE WOOK SHIN, D.M.D. P.C.

Practice address

222 W 14TH St # 7Mezz
New York, NY 10011-7200

Phone

(212) 243-1023

Fax

(212) 243-2510

NPI assigned

Nov 30, 2021

Organization subpart

No

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

Authorized official

Name

Jae Wook Shin, DMDNPI 1225439367

Title

Owner

Phone

(212) 243-1023

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Jae Shin, D.M.D

  • General Practice Dentistry
  • Collingdale, PA
  • NPI 1225439367
  NPD Authorized official

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

{
    "created_epoch": "1638230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638230400000",
    "number": "1538827142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 W 14TH ST # 7MEZZ",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100117200",
            "telephone_number": "212-243-1023",
            "fax_number": "212-243-2510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 W 14TH ST # 7MEZZ",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100117200",
            "telephone_number": "212-243-1023",
            "fax_number": "212-243-2510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAE WOOK SHIN, D.M.D. P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-30",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A",
        "authorized_official_last_name": "SHIN",
        "authorized_official_first_name": "JAE",
        "authorized_official_middle_name": "WOOK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "212-243-1023",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashwin R Jadhav, M.D., M.S.
• Sanjana Jadhav
• Yashodhara Jadhav
• Benjamin M Jadow, MD
• Jady's Kids LLC
• Gina A Jae, M.D.
• Seunghyun Jae
• Jessica Jaeger
• John Thomas Jaeger, PA-C
• Lawrence D Jaeger Sr., DO

• Dental Clinic/Center in New York, NY
• Providers in New York, NY by specialty
• Dental Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2021; 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.