NPIMap

Organization Active NPI

Philip Shin DDS LLC

  • General Practice Dentistry
  • Drexel Hill, PA
National Provider Identifier
1780109397
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS041136 Issued in PA
Legal business name
PHILIP SHIN DDS LLC
Practice address
4130 Bloomfield Ave
Drexel Hill, PA 19026-3803
Phone
(610) 284-4770
Fax
(484) 273-0553
NPI assigned
Aug 4, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Philip H Shin, DDSNPI 1518380310
Title
General Dentist
Phone
(607) 351-4520

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DS041136 PA Primary

Addresses

Primary practice location

4130 Bloomfield Ave
Drexel Hill, PA 19026-3803

Mailing address

4130 Bloomfield Ave
Drexel Hill, PA 19026-3803
Phone (610) 284-4770

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1501804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1780109397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4130 BLOOMFIELD AVE",
            "city": "DREXEL HILL",
            "state": "PA",
            "postal_code": "190263803",
            "telephone_number": "610-284-4770",
            "fax_number": "484-273-0553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4130 BLOOMFIELD AVE",
            "city": "DREXEL HILL",
            "state": "PA",
            "postal_code": "190263803",
            "telephone_number": "610-284-4770",
            "fax_number": "484-273-0553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILIP SHIN DDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-04",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "SHIN",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "GENERAL DENTIST",
        "authorized_official_telephone_number": "607-351-4520",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS041136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Drexel Hill, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.