Individual provider Active NPI

Nathalie Shoer, DMD, MS

  • Oral and Maxillofacial Surgery (Dentist)
  • Lake Mary, FL
National Provider Identifier
1346362597
Registry record updated Jan 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DN-17834 Issued in FL
Practice address
2500 W Lake Mary Blvd
Suite 106
Lake Mary, FL 32746-3501
Phone
(407) 328-6411
Fax
(407) 328-6444
NPI assigned
Apr 6, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DN-17834 FL Primary

Addresses

Primary practice location

2500 W Lake Mary Blvd
Suite 106
Lake Mary, FL 32746-3501

Mailing address

862 Taft CT
Palm Beach Gardens, FL 33410-1567
Phone (787) 378-6930

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160301001059 FL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9830494731

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
DN-17834FLMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Coast Florida P.a. Past Accepting new patients
Coast Florida P.a. PastSince Jun 22, 2021 Accepting new patients

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": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295308800000",
    "number": "1346362597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "862 TAFT CT",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334101567",
            "telephone_number": "787-378-6930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 W LAKE MARY BLVD",
            "address_2": "SUITE 106",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327463501",
            "telephone_number": "407-328-6411",
            "fax_number": "407-328-6444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOER",
        "first_name": "NATHALIE",
        "credential": "DMD, MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-06",
        "last_updated": "2011-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN-17834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

Verify at the official NPI Registry.