NPIMap

Organization Active NPI

Alan D Shoopak DMD Orthodontic Group I LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Fort Myers, FL
National Provider Identifier
1487789475
Registry record updated Oct 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
ALAN D SHOOPAK DMD ORTHODONTIC GROUP I LLC
Practice address
7091 College Pkwy
Ste. 16
Fort Myers, FL 33907-5668
Phone
(239) 433-0921
Fax
(239) 433-0324
NPI assigned
Feb 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2015

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

Authorized official

Name
Dr. Alan D. ShoopakNPI 1205974458
Title
Owner
Phone
(727) 522-5599

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223X0400X FL Primary

Addresses

Primary practice location

7091 College Pkwy
Ste. 16
Fort Myers, FL 33907-5668

Mailing address

6311 4TH St N
St Petersburg, FL 33702-7511
Phone (727) 522-5599

Other names 1

  • Orthodontic Specialists of Florida Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Alan D Shoopak DMD Orthodontic Group I LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

7091 College Pkwy
Ste 16
Fort Myers, FL 33907
Phone (239) 433-0921

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444953600000",
    "number": "1487789475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6311 4TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337027511",
            "telephone_number": "727-522-5599",
            "fax_number": "727-526-1702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7091 COLLEGE PKWY",
            "address_2": "STE. 16",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339075668",
            "telephone_number": "239-433-0921",
            "fax_number": "239-433-0324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALAN D SHOOPAK DMD ORTHODONTIC GROUP I LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2015-10-16",
        "status": "A",
        "authorized_official_last_name": "SHOOPAK",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-522-5599",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Orthodontic Specialists of Florida",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2015; 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.