Alexander Michael Shore, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901600128 Issued in MI

Practice address

18114 Gottschalk Ave
Homewood, IL 60430-2208

Phone

(708) 799-5353

NPI assigned

Jun 17, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Signature Smile Arts, PC

  • General Practice Dentistry
  • Homewood, IL
  • NPI 1619613775
  NPD Authorized official

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

{
    "created_epoch": "1560729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652140800000",
    "number": "1407416977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33153 MAPLENUT ST",
            "city": "FARMINGTON",
            "state": "MI",
            "postal_code": "483364438",
            "telephone_number": "248-345-3521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18114 GOTTSCHALK AVE",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604302208",
            "telephone_number": "708-799-5353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORE",
        "first_name": "ALEXANDER",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-17",
        "last_updated": "2022-05-10",
        "certification_date": "2022-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901600128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julia Eve Shauger, DPM
• Shirley Ann Shaw
• Shawn Thomas DDS PLLC
• Jordyn Lee Sherwood, M.S. CF-SLP
• Terri Kevette Shields
• Vatasia Shorter
• Signature Smile Arts, PC
• J Cory Silver, DPT
• Simply Massage the Wellness Center LLC
• Amarik Singh, D.D.S.,M.S.

• General Practice Dentistry in Homewood, IL
• Providers in Homewood, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2022; 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.