Yongjean Shin, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

49670 Issued in CA

Practice address

1739 S Euclid Ave
Ste a
Ontario, CA 91762-5831

Phone

(909) 983-9325

Fax

(909) 467-9956

NPI assigned

Mar 14, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Chong Il Lee D.D.S a Professional Corporation

  • Dental Clinic/Center
  • Ontario, CA
  • NPI 1164675195
  NPD (past)
• Yong J. Shin, D.D.S. Inc

  • Dental Clinic/Center
  • Ontario, CA
  • NPI 1740693498
  NPD (past)

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462924800000",
    "number": "1760516736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1739 S EUCLID AVE",
            "address_2": "STE A",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917625831",
            "telephone_number": "909-983-9325",
            "fax_number": "909-467-9956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1739 S EUCLID AVE",
            "address_2": "STE A",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917625831",
            "telephone_number": "909-983-9325",
            "fax_number": "909-467-9956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "YONGJEAN",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-14",
        "last_updated": "2016-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "49670",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTICAL RENDERING PROVID",
            "identifier": "D49670",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zirou Shi
• Shield California Health Care Center Inc
• Jefferson Shifter
• Yen Shiu Shih, DDS
• Marnie Shimizu
• Richard Allan Shinto, M.D.
• Amber Shoats
• Daeja Shobey
• Deana M Shoultz, PPSC
• Savannah Shoup

• General Practice Dentistry in Ontario, CA
• Providers in Ontario, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2016; 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.