Craig N. Shore

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

31707 Issued in CA

Practice address

29525 Canwood St
#106
Agoura Hills, CA 91301-4233

Phone

(818) 706-7777

Fax

(818) 706-3473

NPI assigned

Oct 25, 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

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": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760567366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29525 CANWOOD ST",
            "address_2": "#106",
            "city": "AGOURA HILLS",
            "state": "CA",
            "postal_code": "913014233",
            "telephone_number": "818-706-7777",
            "fax_number": "818-706-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29525 CANWOOD ST",
            "address_2": "#106",
            "city": "AGOURA HILLS",
            "state": "CA",
            "postal_code": "913014233",
            "telephone_number": "818-706-7777",
            "fax_number": "818-706-3473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORE",
        "first_name": "CRAIG",
        "middle_name": "N.",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "31707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raquel Sharaf
• Sharon M. Crowder, D.D.S.
• Sharon Ona Functional Nutrition LLC
• Anne Marie Sherman, CMT, NMT
• Sherry Thomas a Professional Corporation
• Michael S Shore, D.C.
• Shelley Showalter, PHD
• Linda Shulman, M.A.
• Siddappa Dental Corporation
• Sienna Shea, Inc.

• General Practice Dentistry in Agoura Hills, CA
• Providers in Agoura Hills, CA by specialty
• General Practice Dentistry in California

• 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.