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General NPI Number Information
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NPI Number | 1558621086
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Entity Type | Individual
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Provider Name | YENSHUO SHEN D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/17/2012
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Last Update Date | 08/09/2016
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Provider Practice Location Address
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Address Line | 116 ELTON HILLS LN NW SUITE 100
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City | ROCHESTER
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State | MN
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Zip | 55901-3602
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Country | US
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Telephone | 507-288-8363
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Fax | 550-728-8445
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Provider Business Mailing Address
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Address Line | 116 ELTON HILLS LN NW SUITE 100
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City | ROCHESTER
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State | MN
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Zip | 55901-3602
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Country | US
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Telephone | 507-288-8363
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Fax | 507-288-4456
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DS039043
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | D13634
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License Number State | MN
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