Individual provider Active NPI

David S Shoaf, DDS

  • General Practice Dentistry
  • Clairton, PA
National Provider Identifier
1780604496
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS027463L Issued in PA
Practice address
502 Walnut Ave
Clairton, PA 15025-2084
Phone
(412) 233-3226
Fax
(412) 233-3864
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS027463L PA Primary

Addresses

Primary practice location

502 Walnut Ave
Clairton, PA 15025-2084

Mailing address

502 Walnut Ave
Clairton, PA 15025-2084
Phone (412) 233-3226

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160201000044 PA Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 4981908670

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS027463LPAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
George J Grisnik Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780604496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 WALNUT AVE",
            "city": "CLAIRTON",
            "state": "PA",
            "postal_code": "150252084",
            "telephone_number": "412-233-3226",
            "fax_number": "412-233-3864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 WALNUT AVE",
            "city": "CLAIRTON",
            "state": "PA",
            "postal_code": "150252084",
            "telephone_number": "412-233-3226",
            "fax_number": "412-233-3864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOAF",
        "first_name": "DAVID",
        "middle_name": "S",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS027463L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clairton, PA

Sources for this page

Verify at the official NPI Registry.