Individual provider Active NPI

Shima N/a Setork, DMD

  • General Practice Dentistry
  • Levelland, TX
National Provider Identifier
1407685118
Registry record updated Apr 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
40645 Issued in TX
Practice address
1000 FM 300
Levelland, TX 79336-6235
Phone
(806) 894-7842
Fax
(806) 894-3378
NPI assigned
Jul 31, 2024
Last updated
Apr 28, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 40645 TX Primary

Addresses

Primary practice location

1000 FM 300
Levelland, TX 79336-6235

Mailing address

7805 Slide Rd
Lubbock, TX 79424-2837
Phone (806) 687-8492

Other practice location 1

7805 Slide Rd
Lubbock, TX 79424-2837
Phone (806) 687-8492

Other identifiers 1

IdentifierTypeStateIssuer
494974502MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20251205003791 TX Practitioner - Dentist 5698268787 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
At Still University, Arizona School of Dentistry & Oral HLTH, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1000 FM
Suite 300
Levelland, TX 79336

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40645TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
South Plains Rural Health Services, Inc. Current Accepting new patients
South Plains Rural Health Services, Inc. CurrentSince Nov 10, 2025 Accepting new patients

Locations

1000 FM 300
Levelland, TX 79336
Phone (806) 894-7842

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1722384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777334400000",
    "number": "1407685118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7805 SLIDE RD",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794242837",
            "telephone_number": "806-687-8492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 FM 300",
            "city": "LEVELLAND",
            "state": "TX",
            "postal_code": "793366235",
            "telephone_number": "806-894-7842",
            "fax_number": "806-894-3378"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7805 Slide Rd",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "794242837",
            "country_code": "US",
            "telephone_number": "806-687-8492",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SETORK",
        "first_name": "SHIMA",
        "middle_name": "N/A",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-31",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "40645",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "494974502",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Levelland, TX

Sources for this page

Verify at the official NPI Registry.