Alan D Shoopak DMD Orthodontic Group IV LLC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

ALAN D SHOOPAK DMD ORTHODONTIC GROUP IV LLC

Doing business as

Orthodontic Specialists of Florida

Practice address

701 Sebastian Blvd
Ste. B
Sebastian, FL 32958-4379

Phone

(772) 388-5666

Fax

(772) 388-2038

NPI assigned

Feb 22, 2007

Last updated

Oct 16, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Alan D. ShoopakNPI 1205974458

Title

Owner

Phone

(727) 522-5599

Specialties & licenses 1

Addresses

Other names 1

• Orthodontic Specialists of Florida Doing business as

Tax ID family

Alan D Shoopak DMD Orthodontic Group IV LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Alan D Shoopak DMD Orthodontic Group IV LLC

  dba Orthodontic Specialists of Florida

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Vero Beach, FL
  • NPI 1417082405
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Alan David Shoopak, D.M.D.,P.A.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • St Petersburg, FL
  • NPI 1205974458
  NPD (past) Authorized official

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444953600000",
    "number": "1174658165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6311 4TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337027511",
            "telephone_number": "727-522-5599",
            "fax_number": "727-526-1702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 SEBASTIAN BLVD",
            "address_2": "STE. B",
            "city": "SEBASTIAN",
            "state": "FL",
            "postal_code": "329584379",
            "telephone_number": "772-388-5666",
            "fax_number": "772-388-2038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALAN D SHOOPAK DMD ORTHODONTIC GROUP IV LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2015-10-16",
        "status": "A",
        "authorized_official_last_name": "SHOOPAK",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-522-5599",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Orthodontic Specialists of Florida",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Orthodontics and Dentofacial Orthopedics Dentistry in Sebastian, FL
• Providers in Sebastian, FL by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2015; 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.