IndividualActive
Bryan Shin
NPI 1689362204 · Pediatric Dentistry · Fishers, IN
Provider details
- NPI number
- 1689362204
- Entity type
- Individual
- Primary specialty
- Pediatric DentistryDental Providers
- Sex
- Male
- Sole proprietor
- No
- License
- 12014784A (IN)
Specialties & taxonomies
Dental Providers
Practice location
13760 Lakeridge Dr
Fishers, IN 46037-7608
Phone: (317) 588-2575
Approximate (ZIP-level) locationGet directions
Mailing address
9723 Northfork Dr
Brentwood, TN 37027-8334
Registry dates
- Enumerated
- 2023-05-01
- Last updated
- 2025-07-17
- Certified
- 2025-07-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.