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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.

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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

Where does Samuel Shine practice?
The practice location on file with NPPES is in Dayton, OH. Providers can have multiple locations; NPPES lists the primary practice address.
What is the NPI number for Samuel Shine?
The National Provider Identifier (NPI) for Samuel Shine is 1124656921, a Type 1 (individual) record in the CMS NPPES registry.

Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2020-03-29.