Shawn Ghods, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

25701 Issued in FL

Practice address

1130 SW St Lucie W Blvd
Suite #206
Port St Lucie, FL 34986

Phone

(772) 807-1451

NPI assigned

Mar 26, 2021

Last updated

Mar 26, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Networks

• Freedom Health HMO Network

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

{
    "created_epoch": "1616716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616716800000",
    "number": "1174100903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5311 NW TORINO LAKES CIR",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349863239",
            "telephone_number": "571-442-4884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 SW ST LUCIE W BLVD",
            "address_2": "SUITE #206",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "34986",
            "telephone_number": "772-807-1451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHODS",
        "first_name": "SHAWN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-26",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "25701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "providedbywork",
            "affiliation": "N",
            "address_1": "1130 SW St Lucie W Blvd",
            "address_2": "Suite #206",
            "city": "Port St lucie",
            "state": "FL",
            "country_code": "US",
            "postal_code": "34986",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Erode Gerve
• Susan Getlik
• Amita Ghanta, PHARM D.
• Salah Gheit, RPH /CONSULTANT PHAR
• Arlene Ghent
• Lauren Jean Giardino, DPT
• Destinie Renae Gibson I, DG
• Jesse Gibson, O.D.
• Gift of Freedom Recovery Center (Gift of Freedom Wellness Center)
• Francine Gilbert, ARNP

• Dentist in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2021; 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.