Shore Drive Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SHORE DRIVE DENTAL

Practice address

4417A Shore Dr
Virginia Beach, VA 23455-2821

Phone

(757) 460-1939

NPI assigned

Oct 20, 2026

Last updated

Oct 20, 2026By the provider in NPPES

Organization subpart

Yes

Parent organization

RIVERSIDE FAMILY DENTISTRYAs reported in NPPES

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

Authorized official

Name

Ritchelle San Juan

Title

Office Administrator

Phone

(757) 478-6856

Specialties & licenses 1

Addresses

Tax ID family

Riverside Family Dentistry2 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.

• Riverside Family Dentistry

  • Dentist
  • Virginia Beach, VA
  • NPI 1811808389
  NPD tax ID

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

{
    "created_epoch": "1792454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1792454400000",
    "number": "1356248868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4417A SHORE DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234552821",
            "telephone_number": "757-460-1939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4417A SHORE DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234552821",
            "telephone_number": "757-460-1939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORE DRIVE DENTAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RIVERSIDE FAMILY DENTISTRY",
        "enumeration_date": "2026-10-20",
        "last_updated": "2026-10-20",
        "certification_date": "2026-10-20",
        "status": "A",
        "authorized_official_last_name": "SAN JUAN",
        "authorized_official_first_name": "RITCHELLE",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "757-478-6856"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Garry Carlton Shoemaker, O.D.
• Melissa Shoemaker
• Rasidat Taiwo Shoge
• Kierstin Shoop
• Shooting Star Counseling, LLC
• Shore Speech, LLC
• Shoreline Counseling & Healing LLC
• Shoreline Physical Medicine and Wellness, LLC
• Karen D Short, RN
• Tanner Short

• General Practice Dentistry in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2026; 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.