Shores Dental PLLC

Primary specialty

DentistTaxonomy code 122300000X

License

13819 Issued in MI

Legal business name

SHORES DENTAL PLLC

Practice address

28503 Little Mack Ave
Saint Clair Shores, MI 48081-1119

Phone

(248) 771-1990

NPI assigned

Feb 27, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Randall Shaw, DDS, MS

Title

Manager

Phone

(248) 931-1151

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1488153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488153600000",
    "number": "1720528599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 PINE RIDGE DR",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483042139",
            "telephone_number": "248-931-1151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28503 LITTLE MACK AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480811119",
            "telephone_number": "248-771-1990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORES DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-27",
        "last_updated": "2017-02-27",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "248-931-1151",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "13819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shorepointe Counseling P.L.C.
• Shorepointe Counseling P.L.C.
• Shorepointe Optical Inc
• Shores Chiropractic Center, PC
• Shores Dental Center, P.C.
• Shores Dental Reflections, PLC
• Shores Foot and Ankle Center LTD.
• Shores Hearing
• Shores Medical Associates PLLC
• Shores of Hope

• Dentist in Saint Clair Shores, MI
• Providers in Saint Clair Shores, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2017; 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.