NPIMap

Organization Active NPI

Alan D. Shoopak D.M.D. ,P.a.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Port Charlotte, FL
National Provider Identifier
1790810935
Registry record updated Oct 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
ALAN D. SHOOPAK D.M.D. ,P.A.
Practice address
1900 Tamiami TRL
Ste. 110
Port Charlotte, FL 33948-2180
Phone
(941) 624-5882
Fax
(941) 624-5818
NPI assigned
Feb 21, 2007
Last updated
Oct 6, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2017

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

Authorized official

Name
Alan David ShoopakNPI 1205974458
Title
Owner
Phone
(727) 522-5599

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X FL Primary

Addresses

Primary practice location

1900 Tamiami TRL
Ste. 110
Port Charlotte, FL 33948-2180

Mailing address

6311 4TH St N
St Petersburg, FL 33702-7511
Phone (727) 522-5599

National Provider Directory

National Provider Directory
Tax ID family
Alan D Shoopak DMD PA10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1900 Tamiami Trl
Unit 110
Port Charlotte, FL 33948
Phone (941) 624-5882

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507248000000",
    "number": "1790810935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6311 4TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337027511",
            "telephone_number": "727-522-5599",
            "fax_number": "727-526-1702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 TAMIAMI TRL",
            "address_2": "STE. 110",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339482180",
            "telephone_number": "941-624-5882",
            "fax_number": "941-624-5818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALAN D. SHOOPAK D.M.D. ,P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2017-10-06",
        "status": "A",
        "authorized_official_last_name": "SHOOPAK",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-522-5599"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2017; 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.