Shady Ashamalla, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

24595 Issued in FL

Practice address

3245 Garden St
Titusville, FL 32796-3004

Phone

(321) 269-2700

NPI assigned

Oct 5, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network

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.

• True Vine Dental Care

  • Dental Clinic/Center
  • Longwood, FL
  • NPI 1477302784
  NPD Authorized official
• Coast Florida P.a.

  • Dentist
  • Titusville, FL
  • NPI 1750957171
  NPD
• Coast Florida P.a.

  • Dentist
  • Tampa, FL
  • NPI 1730287673
  NPD (past)

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

{
    "created_epoch": "1444003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628380800000",
    "number": "1427428374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4951 S WASHINGTON AVE # 32780",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327807319",
            "telephone_number": "602-481-0153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3245 GARDEN ST",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327963004",
            "telephone_number": "321-269-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASHAMALLA",
        "first_name": "SHADY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-05",
        "last_updated": "2021-08-08",
        "certification_date": "2021-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "10238",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "24595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dominique Arguez
• Armstrong Healthcare, LLC
• Kavarus Armstrong
• Christina Ann M Asch, ARNP BC
• Joseph A Asch, MD
• Rebecca Ashby, PTA
• Ashok Shah MD PA
• Christina Avrilien, PHARMD
• Awara Business Enterprises Inc
• B&R Electric Scooters & Lift Chairs Inc.

• Dentist in Titusville, FL
• Providers in Titusville, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.