Active NPI
Slaymon Shukoor, DMD
- Student in an Organized Health Care Education/Training Program
- Gainesville, FL
National Provider Identifier
1245076264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- DN29332
- Practice address
- 1395 Center Dr RM D1-17
Gainesville, FL 32610-4704 - Phone
- (404) 313-1301
- NPI assigned
- Jul 9, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | DN29332 | FL | Primary |
Addresses
Primary practice location
1395 Center Dr RM D1-17
Gainesville, FL 32610-4704
Mailing address
603 N 12TH St Apt 204
Tampa, FL 33602-3267
Phone (404) 313-1301
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN29332 | FL | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Coast Florida P.a. | Dentist | Past | Accepting new patients |
| Coast Florida P.a. | Dentist | Past | Accepting new patients |
Networks
- Freedom Health HMO Network
Organizations & group practices 2
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.
-
- Dentist
- Tampa, FL
- NPI 1174199558
-
- Dentist
- Tampa, FL
- NPI 1730287673
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1720483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1751932800000",
"number": "1245076264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "603 N 12TH ST APT 204",
"city": "TAMPA",
"state": "FL",
"postal_code": "336023267",
"telephone_number": "404-313-1301"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1395 CENTER DR RM D1-17",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326104704",
"telephone_number": "404-313-1301"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHUKOOR",
"first_name": "SLAYMON",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-07-09",
"last_updated": "2025-07-08",
"certification_date": "2025-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "FL",
"license": "DN29332",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Gainesville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.