Dongmin Shin

Primary specialty

PharmacistTaxonomy code 183500000X

License

0202221277 Issued in VA

Practice address

13047 Fair Lakes Shopping Ctr
Fairfax, VA 22033-5179

Phone

(703) 449-8186

NPI assigned

Nov 22, 2023

Last updated

Nov 22, 2023By 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 2

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": "1700611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700611200000",
    "number": "1578338273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12562 SUMMIT MANOR DR APT 303",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220335729",
            "telephone_number": "508-736-8985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13047 FAIR LAKES SHOPPING CTR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220335179",
            "telephone_number": "703-449-8186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "DONGMIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-22",
        "last_updated": "2023-11-22",
        "certification_date": "2023-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "PH241468",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202221277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marianne Shih, M.D.
• Erika G Shilling, PH.D.
• Shiloh Empowerment Services LLC
• Bereket Shimeles
• Dongjin Shin, FNP
• Heekyung Shin, OTR/L
• Hyunki Shin, M.D.
• Jiyeon E. Shin, M.D.
• Julia Shin
• Jacquelynne Kristeen Shinault, BCBA, LBA

• Pharmacist in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Pharmacist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2023; 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.