Shoreline Dental Studio PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SHORELINE DENTAL STUDIO PLLC

Practice address

34 Walter Martin Rd NE
Fort Walton Beach, FL 32548-4960

Phone

(760) 528-0275

NPI assigned

Nov 30, 2021

Last updated

Nov 30, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ashley Dubois, DDSNPI 1053795401

Title

Owner/Member

Phone

(760) 528-0275

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ashley Dubois, D.D.S.

  • General Practice Dentistry
  • Fort Walton Beach, FL
  • NPI 1053795401
  NPD Authorized official

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

{
    "created_epoch": "1638230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638230400000",
    "number": "1750049417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 OKAHATCHEE CIR SE",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325485711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 WALTER MARTIN RD NE",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325484960",
            "telephone_number": "760-528-0275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORELINE DENTAL STUDIO PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-30",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A",
        "authorized_official_last_name": "DUBOIS",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "760-528-0275",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drdubois@shorelinedds.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "34 Walter Martin Rd NE",
            "city": "Fort Walton Beach",
            "state": "FL",
            "country_code": "US",
            "postal_code": "325484960",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Stacy R. Shidemantle, LMT
• Stephanie Lynn Shidemantle, PHARM.D.
• Shifah Counseling Services, PLLC
• Peter H Shih, M.D.
• Kristin Marie Shinnick, D.M.D
• Nancy Shue, LMHC
• Joseph Daniel Siefker, M.D.
• Robert V. Siegel, M.D.
• Sight and Sun Eyeworks LLC (Clarkson Eye Care)
• Colton Sikes, PHARMD

• Dental Clinic/Center in Fort Walton Beach, FL
• Providers in Fort Walton Beach, FL by specialty
• Dental Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2021; 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.