Kyle Aaron Shtern, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

28219 Issued in FL

Practice address

6182 N US Highway 41 Unit a
Apollo Beach, FL 33572-1805

Phone

(813) 771-0329

NPI assigned

Mar 27, 2023

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 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

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.

• Apollo Beach Modern Dentistry, PA

  • General Practice Dentistry
  • Apollo Beach, FL
  • NPI 1912663535
  NPD

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

{
    "created_epoch": "1679875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690934400000",
    "number": "1427751577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 W 168TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323720",
            "telephone_number": "212-305-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6182 N US HIGHWAY 41 UNIT A",
            "city": "APOLLO BEACH",
            "state": "FL",
            "postal_code": "335721805",
            "telephone_number": "813-771-0329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHTERN",
        "first_name": "KYLE",
        "middle_name": "AARON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-27",
        "last_updated": "2023-08-02",
        "certification_date": "2023-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "28219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Seven Lamps LLC
• Angelique Sever
• Sammy Kosco Shahraki, PHARM D
• Shekinah Glory
• Lauren Shirley, PA-C
• Nataliya K Sia, RN, ARNP
• Makaylin Irene Sizemore
• Heather F Slusher, APRN
• Smilelynn Pediatric Dentistry
• Sheena Brooke Smith, LCSW

• General Practice Dentistry in Apollo Beach, FL
• Providers in Apollo Beach, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2023; 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.