Provider Demographics
NPI:1083720056
Name:SHIN, DANIEL CHRISTIAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:CHRISTIAN
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 1:1231 ALA KAPUNA ST APT 308
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819-1294
Mailing Address - Country:US
Mailing Address - Phone:571-888-1909
Mailing Address - Fax:
Practice Address - Street 1:500 ALA MOANA BLVD #220
Practice Address - Street 2:SEVEN WATERFRONT PLAZA
Practice Address - City:HONOLUL
Practice Address - State:HI
Practice Address - Zip Code:96813-9681
Practice Address - Country:US
Practice Address - Phone:808-748-4973
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2019-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014147271223X0400X
MD157911223X0400X
NY0506811223X0400X
HIDT-28081223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty