Patrick J Shine, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

11734 Issued in NC

Practice address

607 Benson Rd Ste a
Garner, NC 27529-3988

Phone

(919) 772-7030

Fax

(919) 772-7810

NPI assigned

Mar 10, 2017

Last updated

Sep 30, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Patrick J. Shine, DMD, P.a.

  dba Shine Family Dentistry

  • General Practice Dentistry
  • Garner, NC
  • NPI 1114693793
  Authorized official Same address or phone

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

{
    "created_epoch": "1489104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632960000000",
    "number": "1912448978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 BENSON RD STE A",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275293988",
            "telephone_number": "919-772-7030",
            "fax_number": "919-772-7810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 BENSON RD STE A",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275293988",
            "telephone_number": "919-772-7030",
            "fax_number": "919-772-7810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHINE",
        "first_name": "PATRICK",
        "middle_name": "J",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-10",
        "last_updated": "2021-09-30",
        "certification_date": "2021-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "11734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kerri Shaw
• Victoria Shawl, MA, NCC, LCMHC
• Sheepless Nights, LLC
• Kristen Amanda Shepherd, APRN
• Kimberly Anne Sherwin, MS CCC-SLP
• Halimah Shire
• Lynnetta Marie Shoop, NP
• Jacob Michael Shuppe, D.C.
• Stephanie Shurtleff, PHARMD
• Grace Siefring

• Dentist in Garner, NC
• Providers in Garner, NC by specialty
• Dentist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2021; 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.