Individual provider Active NPI

Shana H Capra, D.D.S

  • Pediatric Dentistry
  • Delray Beach, FL
National Provider Identifier
1033518485
Registry record updated May 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DN20910 Issued in FL
Practice address
15065 S State Road 7 Ste 650
Delray Beach, FL 33446-4110
Phone
(561) 840-5437
Fax
(561) 840-1042
NPI assigned
Aug 21, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X DN20910 FL Primary

Addresses

Primary practice location

15065 S State Road 7 Ste 650
Delray Beach, FL 33446-4110

Mailing address

15065 S State Road 7 Ste 650
Delray Beach, FL 33446-4110
Phone (561) 840-5437

Other identifiers 1

IdentifierTypeStateIssuer
013292400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN20910FLMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
The Kids Dental Practice Pediatric Dentistry CurrentSince May 24, 2020 Accepting new patients
Dentaland PA Past Accepting new patients

Locations

15065 S State Road 7
Ste 650
Delray Beach, FL 33446
Phone (561) 840-5437

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1408579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589760000000",
    "number": "1033518485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15065 S STATE ROAD 7 STE 650",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334464110",
            "telephone_number": "561-840-5437",
            "fax_number": "561-840-1042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15065 S STATE ROAD 7 STE 650",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334464110",
            "telephone_number": "561-840-5437",
            "fax_number": "561-840-1042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAPRA",
        "first_name": "SHANA",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-21",
        "last_updated": "2020-05-18",
        "certification_date": "2020-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "FL",
            "license": "DN20910",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "013292400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Delray Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.