Shannon Juresich

Primary specialty

DentistTaxonomy code 122300000X

License

27054 Issued in FL

Practice address

4604 N University Dr
Coral Springs, FL 33067-4628

Phone

(631) 702-3283

NPI assigned

May 31, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Joshua Coussa, D.M.D., P.a.

  dba Ideal Dental of Coral Springs

  • Dentist
  • Coral Springs, FL
  • NPI 1437712999
  NPD
• Ideal Dental - Pembroke Pines PLLC

  • Dentist
  • Pembroke Pines, FL
  • NPI 1992479133
  NPD (past)

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

{
    "created_epoch": "1653955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655164800000",
    "number": "1174262976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 SW 1ST AVE APT 1916",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333014372",
            "telephone_number": "631-702-3283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4604 N UNIVERSITY DR",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330674628",
            "telephone_number": "631-702-3283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JURESICH",
        "first_name": "SHANNON",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-31",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "27054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sjuresich@decadental.com",
            "affiliation": "N",
            "address_1": "4604 N University Dr",
            "city": "Coral Springs",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330674628",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Maguy Julmice, RN
• Theresa Ann Junaid, LMT, CNA, PBT
• Junior Smiles LLC
• Carlos Jurado, M.D.
• Melissa Mercedes Jurado, DDS
• Rawan Kablawi, MD
• Kadel Family Chiropractic, LLC
• David Henry Kadel, D.C.
• Prasuna Kadepalli, PA-C
• Sohinee Kadylak

• Dentist in Coral Springs, FL
• Providers in Coral Springs, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2022; 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.