Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Bo Shan, DMD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1538806773

Bo Shan, DMD is a Student in an Organized Health Care Education/Training Program in Newark, New Jersey. Registered with an NPI since 2022.

In the registry since
2022
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

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Practice location Address checks out

110 Bergen St
Newark, NJ 07103-2495
Phone: (973) 943-9346
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1538806773
Entity typeIndividual (Type 1)
GenderMale
Credentials DMD
Sole proprietorNo
NPI enumeratedMay 18, 2022
Last updated in NPPESMay 18, 2022
Certification dateMay 18, 2022
Mailing address407 Cross St, Harrison, NJ 07029-1209

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