Shore Dental, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SHORE DENTAL, LLC

Practice address

4901 White Ibis Drive
North Port, FL 34287

Phone

(941) 474-9548

NPI assigned

Sep 11, 2017

Organization subpart

No

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

Authorized official

Name

Noelle Schmitz

Title

Practice Administrator

Phone

(941) 474-9548

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1505088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505088000000",
    "number": "1114446218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1861 PLACIDA RD STE 105",
            "city": "ENGLEWOOD",
            "state": "FL",
            "postal_code": "342234900",
            "telephone_number": "941-474-9548",
            "fax_number": "941-475-6745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4901 WHITE IBIS DRIVE",
            "city": "NORTH PORT",
            "state": "FL",
            "postal_code": "34287",
            "telephone_number": "941-474-9548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORE DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-11",
        "last_updated": "2017-09-11",
        "status": "A",
        "authorized_official_last_name": "SCHMITZ",
        "authorized_official_first_name": "NOELLE",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "941-474-9548"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yahaira Sheppard
• Morgan Shields
• Ludmila Shimanovsky, M.D.
• Sabrina Shipman, M.S.
• Sharon Patrice Shoch, NCMT
• Hannah Shouppe
• Alex Shulman, RPH
• Kelly Sienko
• Heather Sifford
• Leilani Gail Simmons, LMT

• General Practice Dentistry in North Port, FL
• Providers in North Port, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2017; 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.