Provider Demographics
NPI:1538210638
Name:SHIN, FRANCIS (DDS)
Entity type:Individual
Prefix:
First Name:FRANCIS
Middle Name:
Last Name:SHIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 VALLEY DR STE 2
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06831-5203
Mailing Address - Country:US
Mailing Address - Phone:203-625-0301
Mailing Address - Fax:203-661-2699
Practice Address - Street 1:25 VALLEY DR STE 2
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06831-5203
Practice Address - Country:US
Practice Address - Phone:203-625-0301
Practice Address - Fax:203-661-2699
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0476461223G0001X
CT0096491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02051265Medicaid