Healthcare Provider Details
I. General information
NPI: 1992669600
Provider Name (Legal Business Name): SHING DENTAL GROUP, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1228 GOODMAN RD E STE 2
SOUTHAVEN MS
38671-9540
US
IV. Provider business mailing address
1110 OAKHAVEN CV
TUNICA MS
38676-6157
US
V. Phone/Fax
- Phone: 662-536-2900
- Fax: 662-536-2990
- Phone: 662-902-3540
- Fax: 662-536-2990
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QD0000X |
| Taxonomy | Dental Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
DEVYN
LOU
SHING
Title or Position: OWNER
Credential: DMD
Phone: 662-536-2900