# SHIN PROSTHODONTICS LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PEDG, PEDG Rockville MD LLC, Prostho Endo Dental Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255098620
- **Authorized official:** DR. DONGJIN SHIN DMD (OWNER)
- **Authorized official phone:** (301) 377-8306

## Contact information

- **Practice address:** 5904 HUBBARD DR, NORTH BETHESDA, MD 20852-4823
- **Practice address phone:** (301) 377-8306
- **Practice address fax:** (240) 387-6945
- **Mailing address:** 5904 HUBBARD DR, NORTH BETHESDA, MD 20852-4823
- **Mailing address phone:** (301) 377-8306
- **Mailing address fax:** (240) 387-6945

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | — | — | — |
| 1223G0001X | General Practice Dentistry | — | — | — |
| 1223P0700X | Prosthodontics | — | — | Yes |
| 261QD0000X | Dental Clinic/Center | — | — | — |

## Other

- **Enumeration date:** 11/20/2021
- **Last updated:** 09/10/2026