Active NPI
Alice Kamo Shoemaker, D.D.S.
- Dentist
- La Selva Beach, CA
National Provider Identifier
1386822302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 32764
- Practice address
- 167 El Pinar
La Selva Beach, CA 95076-1509 - Phone
- (831) 684-1417
- NPI assigned
- Jan 31, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 32764 | CA | Primary |
Addresses
Primary practice location
167 El Pinar
La Selva Beach, CA 95076-1509
Mailing address
167 El Pinar
La Selva Beach, CA 95076-1509
Phone (831) 684-1417
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1201737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201737600000",
"number": "1386822302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "167 EL PINAR",
"city": "LA SELVA BEACH",
"state": "CA",
"postal_code": "950761509",
"telephone_number": "831-684-1417"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "167 EL PINAR",
"city": "LA SELVA BEACH",
"state": "CA",
"postal_code": "950761509",
"telephone_number": "831-684-1417"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHOEMAKER",
"first_name": "ALICE",
"middle_name": "KAMO",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-01-31",
"last_updated": "2008-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "32764",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Selva Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.