Provider Demographics
NPI:1467527416
Name:SHIN, BOWMAN YOUNG (DMD)
Entity Type:Individual
Prefix:DR
First Name:BOWMAN
Middle Name:YOUNG
Last Name:SHIN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 BIG TREE DR NW
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-5611
Mailing Address - Country:US
Mailing Address - Phone:425-260-8390
Mailing Address - Fax:425-774-5727
Practice Address - Street 1:19108 33RD AVE W STE C
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-4728
Practice Address - Country:US
Practice Address - Phone:425-774-9571
Practice Address - Fax:425-774-5727
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-22
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE0008921122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist