Samuel Jacob Shine
Samuel Jacob Shine is a Student in an Organized Health Care Education/Training Program provider (Student in an Organized Health Care Education/Training Program) practicing in Dayton, OH, registered in the NPPES registry with NPI 1124656921 since 2020.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1124656921 |
|---|---|
| Entity type | Individual (Type 1) |
| Name | Samuel Jacob Shine |
| Sex | Male |
| Practice address | 405 W GRAND AVE, Dayton, OH, 45405 |
| Phone | 9377233245 |
| Enumeration date | 2020-03-29 |
| Last updated in NPPES | 2020-03-29 |
Taxonomy & licenses
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | Primary | — | — |
Copy-ready billing details
Provider: Samuel Shine NPI: 1124656921 Taxonomy: 390200000X (Student in an Organized Health Care Education/Training Program) Address: 405 W GRAND AVE, Dayton, OH, 45405
Other providers at this practice address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1417956772 | Michael Boggs | Individual | Hospitalist Physician | Dayton, OH |
| 1912996927 | Thomas Spitzer | Individual | Pharmacist | Dayton, OH |
| 1821079369 | Anne Reddington | Individual | Hospitalist Physician | Dayton, OH |
| 1073598249 | Judy Parkat | Individual | Specialist | Dayton, OH |
| 1619952884 | Southview Pathologists, Inc | Organization | Specialist | Dayton, OH |
| 1528043791 | Bernard Fox | Individual | Specialist | Dayton, OH |
| 1750369146 | Kent Bennett | Individual | Student in an Organized Health Care Education/Training Program | Dayton, OH |
| 1538134994 | Christopher Tidwell | Individual | Emergency Medicine Physician | Dayton, OH |
Verify this record
Cross-check NPI 1124656921 against the authoritative CMS record: view Samuel Jacob Shine on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
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Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2020-03-29.