Active NPI
Seunghwa Sarah Shin, D.D.S
- Dentist
- Flushing, NY
National Provider Identifier
1730455528
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 057044-1
- Practice address
- 19402 Northern Blvd
#LL1
Flushing, NY 11358-3002 - Phone
- (347) 368-4237
- NPI assigned
- Mar 27, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 057044-1 | NY | Primary |
Addresses
Primary practice location
19402 Northern Blvd
#LL1
Flushing, NY 11358-3002
Mailing address
19402 Northern Blvd
Flushing, NY 11358-3002
Phone (347) 368-4237
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
| License | State | Type | Specialty |
|---|---|---|---|
| 057044-1 | NY | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pleasant Dental PLLC | Past | 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 and National Provider Directory roles.
-
- General Practice Dentistry
- Flushing, NY
- NPI 1851549075
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1332806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1419811200000",
"number": "1730455528",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19402 NORTHERN BLVD",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113583002",
"telephone_number": "347-368-4237"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19402 NORTHERN BLVD",
"address_2": "#LL1",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113583002",
"telephone_number": "347-368-4237"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIN",
"first_name": "SEUNGHWA",
"middle_name": "SARAH",
"credential": "D.D.S",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-03-27",
"last_updated": "2014-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "057044-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flushing, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.