{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SHING DENTAL GROUP, PLLC",
"LastName": null,
"FirstName": null,
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"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1110 OAKHAVEN CV",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "TUNICA",
"MailingAddressStateName": "MS",
"MailingAddressPostalCode": "38676-6157",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "662-902-3540",
"MailingAddressFaxNumber": "662-536-2990",
"FirstLinePracticeLocationAddress": "1228 GOODMAN RD E STE 2",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SOUTHAVEN",
"PracticeLocationAddressStateName": "MS",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "662-536-2900",
"PracticeLocationAddressFaxNumber": "662-536-2990",
"EnumerationDate": "12/16/2025",
"LastUpdateDate": "12/16/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SHING",
"AuthorizedOfficialFirstName": "DEVYN",
"AuthorizedOfficialMiddleName": "LOU",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DMD",
"AuthorizedOfficialTelephoneNumber": "662-536-2900",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QD0000X",
"TaxonomyName": "Dental Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}