Sang Yoon Shin, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9744 Issued in WA

Practice address

205 117TH St S
Tacoma, WA 98444-5409

Phone

(253) 531-7111

Fax

(253) 531-7112

NPI assigned

Jan 17, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Shin D.D.S., P.S., LLC

  dba Pacific Family Dentistry

  • Dental Clinic/Center
  • Tacoma, WA
  • NPI 1699942946
  NPD (past) Authorized official

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821140997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8845 BEDINGTON DR SE",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985133413",
            "telephone_number": "360-491-4756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 117TH ST S",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984445409",
            "telephone_number": "253-531-7111",
            "fax_number": "253-531-7112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "SANG",
        "middle_name": "YOON",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "9744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Min Shim
• Shumona Shimi, LCSW
• Shin D.D.S., P.S., LLC (Pacific Family Dentistry)
• Nan Shin Moynihan, DO
• Michelle Shin, DC
• Wonita Shin
• Marian C Shinobu, M.D.
• Sean Michael Shipley, PA-C
• Mansour V Shirbacheh, MD
• Anissa Shirley

• General Practice Dentistry in Tacoma, WA
• Providers in Tacoma, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.