Alan David Shoopak, D.M.D.,P.A.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DN9319 Issued in FL

Practice address

6311 4TH St N
St Petersburg, FL 33702-7511

Phone

(727) 522-5599

Fax

(727) 526-1702

NPI assigned

Feb 1, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Apr 25, 2017 through Apr 25, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Affiliated Dental Specialist

  • General Practice Dentistry
  • Brandon, FL
  • NPI 1497106033
  NPD (past) Authorized official
• Affiliated Dental Specialist PL

  • General Practice Dentistry
  • Tampa, FL
  • NPI 1215457767
  NPD (past) Authorized official
• Affiliated Dental Specialist PL

  • General Practice Dentistry
  • Tampa, FL
  • NPI 1801316310
  NPD (past) Authorized official
• Afilliated Dental Specialist PL

  • General Practice Dentistry
  • Palm Harbor, FL
  • NPI 1336669852
  NPD (past) Authorized official
• Afilliated Dental Specialist PL

  • General Practice Dentistry
  • Spring Hill, FL
  • NPI 1629598131
  NPD (past) Authorized official
• Afilliated Dental Specialist PL

  • Dentist
  • Miami, FL
  • NPI 1871043083
  NPD (past) Authorized official
• Alan D Shoopak DMD Orthodontic Group I LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Naples, FL
  • NPI 1356476352
  NPD (past) Authorized official
• Alan D Shoopak DMD Orthodontic Group I LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Fort Myers, FL
  • NPI 1487789475
  NPD (past) Authorized official
• Alan D Shoopak DMD Orthodontic Group II LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Miami, FL
  • NPI 1003941907
  NPD (past) Authorized official
• Alan D Shoopak DMD Orthodontic Group II LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Davie, FL
  • NPI 1912234493
  NPD (past) Authorized official
• Alan D Shoopak DMD Orthodontic Group II LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Cutler Bay, FL
  • NPI 1982739892
  NPD (past) Authorized official
• Alan D Shoopak DMD Orthodontic Group IV LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Sebastian, FL
  • NPI 1174658165
  NPD (past) Authorized official

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507248000000",
    "number": "1205974458",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOOPAK",
        "first_name": "ALAN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.M.D.,P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-01",
        "last_updated": "2017-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MA",
            "license": "DN15199",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "FL",
            "license": "DN9319",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110010278A",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "075690300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Reba E Shoenfelt, ARNP
• Scott Shoenfelt, PHARMD
• April K Shook, D.C.
• Richard Deneen Shook, D.C.
• Aaron Shoopak, D.M.D.
• Anna Shoopak, D.M.D.
• Shore Acres Nursing and Rehab LLC
• Shore Facility Inc
• Shoreline Counselor
• Shoreline Psychological Services, LLC

• Orthodontics and Dentofacial Orthopedics Dentistry in St Petersburg, FL
• Providers in St Petersburg, 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 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.