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General NPI Number Information
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NPI Number | 1487580684
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Entity Type | Organization
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Legal Business Name | MYUNG SHIK SHIN DDS INC
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Dates
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Enumeration Date | 06/23/2026
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Last Update Date | 06/23/2026
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Provider Practice Location Address
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Address Line | 301 E BUENA VISTA ST
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City | BARSTOW
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State | CA
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Zip | 92311-2803
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Country | US
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Telephone | 909-328-9713
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Fax |
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Provider Business Mailing Address
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Address Line | 26149 PARK AVE UNIT 1
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City | LOMA LINDA
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State | CA
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Zip | 92354-6128
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MYUNG SHIK SHIN
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Credential |
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Telephone | 909-328-9713
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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