| Teeho Specialty Group Llc | |
|
1325 18th St Nw Ste 203 Washington DC 20036-6501 | |
| (202) 716-7626 | |
| Not Available |
| Full Name | Teeho Specialty Group Llc |
|---|---|
| Speciality | Dentist |
| Location | 1325 18th St Nw Ste 203, Washington, District Of Columbia |
| Authorized Official Name and Position | Thomas Shin (OWNER) |
| Authorized Official Contact | 2027167626 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Teeho Specialty Group Llc 1325 18th St Nw Ste 203 Washington DC 20036-6501 Ph: (202) 716-7626 | Teeho Specialty Group Llc 1325 18th St Nw Ste 203 Washington DC 20036-6501 Ph: (202) 716-7626 |
| NPI Number | 1851738967 |
|---|---|
| Provider Enumeration Date | 05/30/2013 |
| Last Update Date | 02/15/2023 |
| Medicare PECOS PAC ID | 4082844220 |
|---|---|
| Medicare Enrollment ID | O20140307000995 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851738967 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | DEN1001175 (District Of Columbia) | Primary |
| Provider Name | Thomas Keun Ho Shin |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1154687218 PECOS PAC ID: 5991935132 Enrollment ID: I20140307001109 |
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