Provider Demographics
NPI:1346608676
Name:GEORGE B. SHINN DDS P.C
Entity Type:Organization
Organization Name:GEORGE B. SHINN DDS P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:B
Authorized Official - Last Name:SHINN
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:310-649-3636
Mailing Address - Street 1:8540 S SEPULVEDA BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-3807
Mailing Address - Country:US
Mailing Address - Phone:310-649-3636
Mailing Address - Fax:310-649-3638
Practice Address - Street 1:8540 S SEPULVEDA BLVD
Practice Address - Street 2:#1200
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90045-3807
Practice Address - Country:US
Practice Address - Phone:310-649-3636
Practice Address - Fax:310-649-3638
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-01
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA243411223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty