Jennifer Hae Su Shin, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DDS102028 Issued in CA

Practice address

17024 Clark Ave Ste C
Bellflower, CA 90706-5700

Phone

(213) 810-1318

NPI assigned

Apr 19, 2016

Sex

Female

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

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Jennifer Shin DDS Inc

  • Dentist
  • Bellflower, CA
  • NPI 1033970959
  NPD Authorized official

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

{
    "created_epoch": "1461024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1982058632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 ELDEN AVE UNIT 305",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900065845",
            "telephone_number": "213-810-1318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17024 CLARK AVE STE C",
            "city": "BELLFLOWER",
            "state": "CA",
            "postal_code": "907065700",
            "telephone_number": "213-810-1318"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1775 Grand Concourse",
            "address_2": "6th Floor",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104538202",
            "country_code": "US",
            "telephone_number": "718-901-8410",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Venice Blvd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900153232",
            "country_code": "US",
            "telephone_number": "213-747-8899",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIN",
        "first_name": "JENNIFER",
        "middle_name": "HAE SU",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-19",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS102028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David M Shigekuni, OD
• Darren K. Shimabukuro, MD
• Amy Shimada, PHARMD
• Shin Kuan Lin MD Inc
• Janet Shin, PHARMD
• Zachary McCoy Shinar, M.D.
• Kevin M. Shiramizu, MD
• Ayodele Tracy Shittu, CATC I
• Shuchita Gupta, DDS ,Inc.
• Glenn K. Shulman, MD

• Dentist in Bellflower, CA
• Providers in Bellflower, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 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.

Verify at the official NPI Registry.