Nodesh Shyamsunder, B.D.S

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

DN20907 Issued in FL

Practice address

324 3Rd Ave N
Jacksonville Beach, FL 32250-5602

Phone

(904) 246-6714

NPI assigned

Aug 21, 2014

Sex

Male

Sole proprietor

Yes

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

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.

Opted out of Medicare

Yes, effective Dec 27, 2022 through Dec 27, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Dental Summit PLLC

  • Prosthodontics
  • Jacksonville Beach, FL
  • NPI 1588172571
  NPD (past) Authorized official

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

{
    "created_epoch": "1408579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1720487135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 3RD AVE N",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322505602",
            "telephone_number": "904-246-6714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 3RD AVE N",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322505602",
            "telephone_number": "904-246-6714"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7250 College Pkwy",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339075606",
            "country_code": "US",
            "telephone_number": "239-939-7070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHYAMSUNDER",
        "first_name": "NODESH",
        "name_prefix": "Dr.",
        "credential": "B.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-21",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "FL",
            "license": "DN20907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eleni Sheklin, LCSW
• Anita R Sheldon, RN
• Shining Star Living Services, LLC
• Neil Thomas Shmunes, M.D.
• Eric W Shultz, DPM
• Tracy Sieber
• Hunter Austin Simes
• Richard L Simmons, M.D.
• Bethany B Simpson, MS, CCC-SLP
• Carrie Simpson, LMHC

• Prosthodontics in Jacksonville Beach, FL
• Providers in Jacksonville Beach, FL by specialty
• Prosthodontics in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.