Jean Shin, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

34936 Issued in TX

Practice address

14207 Coit Rd Ste 112
Dallas, TX 75254-2839

Phone

(214) 420-7008

NPI assigned

Jul 2, 2018

Sex

Female

Sole proprietor

No

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Sep 25, 2019 through Sep 25, 2027

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 and National Provider Directory roles.

• Spring Valley Crossing Dental, P.a.

  • General Practice Dentistry
  • Dallas, TX
  • NPI 1497908784
  NPD (past)
• Cedar Pearl Dental, LLC

  • General Practice Dentistry
  • Crestview, FL
  • NPI 1902790348
  NPD (past)

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

{
    "created_epoch": "1530489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561248000000",
    "number": "1992291017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2233 MUSTANG TRL",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750338379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14207 COIT RD STE 112",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752542839",
            "telephone_number": "214-420-7008"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "222 Cedar Ave",
            "address_purpose": "LOCATION",
            "city": "Crestview",
            "state": "FL",
            "postal_code": "325362706",
            "country_code": "US",
            "telephone_number": "850-682-2720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIN",
        "first_name": "JEAN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-02",
        "last_updated": "2019-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN23475",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "34936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Shiloh, M.D., PH.D.
• Thomas Shima, DO
• Shoichi Shimamoto, M.D.
• Tricia A Shimer, MDPA
• Tyler Shimfessel
• Jiwon Shin
• Joo Hyun Shin, MD
• Kang S Shin, RPH
• Laurel Mira Shin, DMD
• Leeshik Shin, D.D.S.

• General Practice Dentistry in Dallas, TX
• Providers in Dallas, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.