Active NPI
Yoon Shin, DDS
- General Practice Dentistry
- Laurel, MD
National Provider Identifier
1902646334
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 18102
- Practice address
- 8339 Cherry LN
Laurel, MD 20707-4828 - Phone
- (301) 498-0545
- NPI assigned
- May 31, 2024
- Last updated
- May 31, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 18102 | MD | Primary |
Addresses
Primary practice location
8339 Cherry LN
Laurel, MD 20707-4828
Mailing address
8482 Jacqueline CT
Jessup, MD 20794-3414
Phone (301) 509-3060
Other practice location 1
100 Crain Hwy S
Glen Burnie, MD 21061-3528
Phone (410) 969-9300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18102 | MD | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Smile Up Dental Center | General Practice | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Glen Burnie Dental Group
- General Practice Dentistry
- Glen Burnie, MD
- NPI 1679920938
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1717113600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717113600000",
"number": "1902646334",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8482 JACQUELINE CT",
"city": "JESSUP",
"state": "MD",
"postal_code": "207943414",
"telephone_number": "301-509-3060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8339 CHERRY LN",
"city": "LAUREL",
"state": "MD",
"postal_code": "207074828",
"telephone_number": "301-498-0545"
}
],
"practiceLocations": [
{
"address_1": "100 Crain Hwy S",
"address_purpose": "LOCATION",
"city": "Glen Burnie",
"state": "MD",
"postal_code": "210613528",
"country_code": "US",
"telephone_number": "410-969-9300",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHIN",
"first_name": "YOON",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-05-31",
"last_updated": "2024-05-31",
"certification_date": "2024-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MD",
"license": "18102",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Laurel, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.