Shine Orthodontics

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

SHINE ORTHODONTICS

Practice address

1120 Western Ave
Chillicothe, OH 45601-1174

Phone

(740) 773-0072

Fax

(800) 507-0629

NPI assigned

Sep 15, 2023

Organization subpart

No

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

Authorized official

Name

Connie Lynn Watkins

Title

Insurance Admin

Phone

(740) 773-0072

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.

• Michael Agenter, DDS, MDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Chillicothe, OH
  • NPI 1548404585
  NPD

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

{
    "created_epoch": "1694736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694736000000",
    "number": "1730967399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 WESTERN AVE",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456011174",
            "telephone_number": "740-773-0072",
            "fax_number": "800-507-0629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 WESTERN AVE",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456011174",
            "telephone_number": "740-773-0072",
            "fax_number": "800-507-0629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHINE ORTHODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-15",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-14",
        "status": "A",
        "authorized_official_last_name": "WATKINS",
        "authorized_official_first_name": "CONNIE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "INSURANCE ADMIN",
        "authorized_official_telephone_number": "740-773-0072"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward J Sheridan, M.D.
• Jaime Sherman
• Zachary Ryan Sherman
• Nathan D Shiflett, DO
• Shine Orthodontics
• Darlene Shively, OTR/L
• Aaron Bruce Shoemaker
• Cameron Paige Shoemaker, DO
• Rebecca Lynn Shoemaker
• Stacy Lynn Shoemaker, ORT/L

• Orthodontics and Dentofacial Orthopedics Dentistry in Chillicothe, OH
• Providers in Chillicothe, OH by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 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.