Individual provider Active NPI

Slaymon Shukoor, DMD

  • Student in an Organized Health Care Education/Training Program
  • Gainesville, FL
National Provider Identifier
1245076264
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
DN29332 Issued in FL
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

Updated by the provider on Jul 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
DN29332FLMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Coast Florida P.a. Dentist PastSince Jul 1, 2024 Accepting new patients
Coast Florida P.a. Dentist PastSince Jul 1, 2024 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.

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.

Verify at the official NPI Registry.