Shadan Yassine, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

24399 Issued in FL

Practice address

433 Apollo Beach Blvd
Apollo Beach, FL 33572-2281

Phone

(813) 341-0102

NPI assigned

Aug 10, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lane and Associates Xxxi DDS PA

  • General Practice Dentistry
  • Mebane, NC
  • NPI 1760911689
  NPD
• Sean M Gassett, D.MD., P.a.

  dba Apollo Beach Dental Excellence

  • General Practice Dentistry
  • Apollo Beach, FL
  • NPI 1275702953
  NPD (past)
• Karen R. Bremer D.D.S., R.D.H. & Associates P.L.L.C

  • General Practice Dentistry
  • Durham, NC
  • NPI 1457523979
  NPD (past)
• Lane and Associates VI DDS PA

  • General Practice Dentistry
  • Durham, NC
  • NPI 1295990406
  NPD (past)
• Zhanying Guo DDS PA

  dba Complete Dental Care of Mebane

  • Dental Clinic/Center
  • Mebane, NC
  • NPI 1891021614
  NPD (past)

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

{
    "created_epoch": "1565395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1790331379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "433 APOLLO BEACH BLVD",
            "city": "APOLLO BEACH",
            "state": "FL",
            "postal_code": "335722281",
            "telephone_number": "813-341-0102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 APOLLO BEACH BLVD",
            "city": "APOLLO BEACH",
            "state": "FL",
            "postal_code": "335722281",
            "telephone_number": "813-341-0102"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2700 S Miami Blvd",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NC",
            "postal_code": "277039416",
            "country_code": "US",
            "telephone_number": "919-598-9900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1242 S Fifth St Ste D",
            "address_purpose": "LOCATION",
            "city": "Mebane",
            "state": "NC",
            "postal_code": "273029756",
            "country_code": "US",
            "telephone_number": "919-304-1666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YASSINE",
        "first_name": "SHADAN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-10",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "11590",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "24399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://apollobeachdental.com/",
            "affiliation": "N",
            "address_1": "433 Apollo Beach Blvd",
            "city": "Apollo Beach",
            "state": "FL",
            "country_code": "US",
            "postal_code": "335722281",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Andrew Win
• William Withers
• Jonathan Woolverton, APRN
• Wound Logix Inc
• Jin Yang, OD, PHD
• Linda Zachar

• General Practice Dentistry in Apollo Beach, FL
• Providers in Apollo Beach, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.