Individual provider Active NPI

James Allan Shaul, D.D.S.

  • Dentist
  • Camp Lejeune, NC
National Provider Identifier
1063724029
Registry record updated Oct 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS038308 Issued in PA
Practice address
700 McHugh Blvd
Camp Lejeune, NC 28542-0130
Phone
(910) 450-1658
Fax
(910) 451-8036
NPI assigned
Jul 7, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 09623 NC
Dentist 122300000X DS038308 PA Primary

Addresses

Primary practice location

700 McHugh Blvd
Camp Lejeune, NC 28542-0130

Mailing address

2D Denbn/NDC, PSC Box 20130
Commanding Officer
Camp Lejeune, NC 28542-0130
Phone (910) 451-2208

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
09623NCMDDentist
DS038308PAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1278460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1063724029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2D DENBN/NDC, PSC BOX 20130",
            "address_2": "COMMANDING OFFICER",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "285420130",
            "telephone_number": "910-451-2208",
            "fax_number": "910-451-8036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 MCHUGH BLVD",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "285420130",
            "telephone_number": "910-450-1658",
            "fax_number": "910-451-8036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAUL",
        "first_name": "JAMES",
        "middle_name": "ALLAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-07",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "09623",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS038308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camp Lejeune, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2023; 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.