Individual provider Active NPI

Shanna Sarah Bernkrant, DMD

  • Dentist
  • FL, FL
National Provider Identifier
1366730236
Registry record updated May 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
19628 Issued in TX
Practice address
12404 W Dixie Hwy
North Miami
FL, FL 33161
Phone
(305) 893-4801
NPI assigned
Jul 13, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 19628 TX Primary
Student in an Organized Health Care Education/Training Program 390200000X ETN4 TX

Addresses

Primary practice location

12404 W Dixie Hwy
North Miami
FL, FL 33161

Mailing address

12404 W Dixie Hwy
North Miami
FL, FL 33161
Phone (305) 893-4801

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
I20160310000782 FL Order and Referring Only - DentistPractitioner - Dentist 4789980137

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19628TXMDProfessional Counselor
ETN4TXMDStudent in an Organized Health Care Education/Training Program

Practice roles (3 of 4)

OrganizationSpecialtyStatusNew patients
All Smiles General Dentistry II, P.a. Current Accepting new patients
Beach Smile Family Dentistry, P.a. CurrentSince Feb 14, 2021 Accepting new patients
All Smiles General Dentistry Dentist Past Accepting new patients

Locations

18360 NW 7th Ave
Miami Gardens, FL 33169
Phone 30563764002151

2242 NE 123rd St
North Miami, FL 33181
Phone (305) 866-9998

Networks

  • Freedom Health HMO Network

Organizations & group practices 3

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": "1310515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431648000000",
    "number": "1366730236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12404 W DIXIE HWY",
            "address_2": "NORTH MIAMI",
            "city": "FL",
            "state": "FL",
            "postal_code": "33161",
            "telephone_number": "305-893-4801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12404 W DIXIE HWY",
            "address_2": "NORTH MIAMI",
            "city": "FL",
            "state": "FL",
            "postal_code": "33161",
            "telephone_number": "305-893-4801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNKRANT",
        "first_name": "SHANNA",
        "middle_name": "SARAH",
        "name_prefix": "Ms.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-13",
        "last_updated": "2015-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "19628",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "ETN4",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in FL, FL

Sources for this page

Verify at the official NPI Registry.