Lauren Beth Shack, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

ON0014377 Issued in FL

Practice address

685 Royal Palm Beach Blvd
Suite #203
Royal Palm Beach, FL 33411

Phone

(561) 792-1212

NPI assigned

Apr 17, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189728000000",
    "number": "1043436447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "685 ROYAL PALM BEACH BLVD",
            "address_2": "SUITE #203",
            "city": "ROYAL PALM BEACH",
            "state": "FL",
            "postal_code": "33411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "685 ROYAL PALM BEACH BLVD",
            "address_2": "SUITE #203",
            "city": "ROYAL PALM BEACH",
            "state": "FL",
            "postal_code": "33411",
            "telephone_number": "561-792-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHACK",
        "first_name": "LAUREN",
        "middle_name": "BETH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2007-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "FL",
            "license": "ON0014377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Craig Mitchell Senzon, M.D.
• Serenity Therapy Solutions Corp
• Tina Marie Sevilla, APRN, FNP-BC
• SF Royal Manor LLC (Royal Palm Beach Health and Rehabilitation Center)
• Stela Shabani, PA-C
• Shafa Pharmacy
• Faiza Shafique, APRN
• Shamila Sukhnandan
• Laibao Shao, A.P.
• Gail Shapiro

• Periodontics in Royal Palm Beach, FL
• Providers in Royal Palm Beach, FL by specialty
• Periodontics in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.