NPIMap

Organization Active NPI

Yong J Shin D.D.S. Inc,

Doing business as Hesperia Central Dental

  • Dental Clinic/Center
  • Hesperia, CA
National Provider Identifier
1770736399
Registry record updated Oct 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
49670 Issued in CA
Legal business name
YONG J SHIN D.D.S. INC,
Doing business as
Hesperia Central Dental
Practice address
16922 Main St Ste F
Hesperia, CA 92345-6011
Phone
(760) 244-4844
Fax
(760) 244-5002
NPI assigned
Oct 28, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2008

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

Authorized official

Name
Dr. Yong J Shin, DDS
Title
Ceo
Phone
(760) 244-4844

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 49670 CA Primary

Addresses

Primary practice location

16922 Main St Ste F
Hesperia, CA 92345-6011

Mailing address

16922 Main St Ste F
Hesperia, CA 92345-6011
Phone (760) 244-4844

Other identifiers 1

IdentifierTypeStateIssuer
49670OtherCACALIFORNIA DENTIST LISENCE

Other names 1

  • Hesperia Central Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Yong J Shin DDS Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

16922 Main St
Ste F
Hesperia, CA 92345
Phone (760) 244-4844

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225152000000",
    "number": "1770736399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16922 MAIN ST STE F",
            "city": "HESPERIA",
            "state": "CA",
            "postal_code": "923456011",
            "telephone_number": "760-244-4844",
            "fax_number": "760-244-5002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16922 MAIN ST STE F",
            "city": "HESPERIA",
            "state": "CA",
            "postal_code": "923456011",
            "telephone_number": "760-244-4844",
            "fax_number": "760-244-5002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YONG J SHIN D.D.S. INC,",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-28",
        "last_updated": "2008-10-28",
        "status": "A",
        "authorized_official_last_name": "SHIN",
        "authorized_official_first_name": "YONG J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "760-244-4844",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CA",
            "license": "49670",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA DENTIST LISENCE",
            "identifier": "49670",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hesperia Central Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hesperia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2008; 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.