Dr. Jin Sup Shin, DDS, P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

DR. JIN SUP SHIN, DDS, P.C.

Doing business as

SmileWorks

Practice address

30 Central Park S RM 11D
New York, NY 10019-1649

Phone

(917) 971-3232

NPI assigned

Aug 29, 2022

Last updated

Aug 29, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jin Sup Shin, DDSNPI 1356999510

Title

Owner

Phone

(917) 971-3232

Specialties & licenses 2

Addresses

Other names 1

• SmileWorks Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jin Sup Shin, DDS, MS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • New York, NY
  • NPI 1356999510
  NPD Authorized official

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

{
    "created_epoch": "1661731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661731200000",
    "number": "1710607981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 CENTRAL PARK S RM 11D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191649",
            "telephone_number": "917-971-3232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 CENTRAL PARK S RM 11D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191649",
            "telephone_number": "917-971-3232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. JIN SUP SHIN, DDS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-29",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A",
        "authorized_official_last_name": "SHIN",
        "authorized_official_first_name": "JIN SUP",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-971-3232",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SmileWorks",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in New York, NY
• Providers in New York, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2022; 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.