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NPI Code Detail

MEDICARE: DR. EUNSOOK SHIN DDS

MEDICARE: DR. EUNSOOK SHIN DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist2644NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1881794204
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EUNSOOK SHIN DDS
Provider Business Mailing Address
First Line : 3325 RESEARCH WAY
Second Line :
City : CARSON CITY
State : NV
Zip : 89706-7913
Country : US
Telephone Number : 775-888-6610
Fax Number : 775-888-4904
Provider Business Practice Location Address
First Line : 2212 S EASTERN AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89104-4124
Country : US
Telephone Number : 702-735-9334
Fax Number : 702-735-9335
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2006
Last Update Date : 04/27/2016

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Directions to “ DR. EUNSOOK SHIN DDS” Practice Location

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