Philip A Shore, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS019091L Issued in PA

Practice address

200 Treaty Rd
Drexel Hill, PA 19026-5023

Phone

(610) 449-2424

NPI assigned

Dec 11, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750441408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 TREATY RD",
            "city": "DREXEL HILL",
            "state": "PA",
            "postal_code": "190265023",
            "telephone_number": "610-449-2424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 TREATY RD",
            "city": "DREXEL HILL",
            "state": "PA",
            "postal_code": "190265023",
            "telephone_number": "610-449-2424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORE",
        "first_name": "PHILIP",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS019091L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "159499",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Roland E Shelton Jr., MSW
• Rosemary Johanna Shields, RN
• Sabura Shiffrin, PT
• Wan S Shim, MD
• Taraya J Shirdan
• Julia Bye Siegerman, D.P.M.
• Lucas Silveri-Hiller, PT, DPT
• David Bruce Simpson, MSW, LCSW, C-ASWCM
• Crystal Singh
• Tameka Sisco, D.O

• General Practice Dentistry in Drexel Hill, PA
• Providers in Drexel Hill, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.