NPIMap

Organization Active NPI

Mark a Shousha, DDS PC

Doing business as Bayshore Dental Group

  • Dentist
  • Chandler, AZ
National Provider Identifier
1811199284
Registry record updated Jul 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
4329 Issued in AZ
Legal business name
MARK A SHOUSHA, DDS PC
Doing business as
Bayshore Dental Group
Practice address
1100 N Alma School Rd
Suite 7
Chandler, AZ 85224-3171
Phone
(480) 855-4444
Fax
(480) 857-3866
NPI assigned
Jun 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2009

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

Authorized official

Name
Dr. Mark Alfred Shousha, DDSNPI 1841274487
Title
President
Phone
(480) 855-4444

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
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 4329 AZ Primary

Addresses

Primary practice location

1100 N Alma School Rd
Suite 7
Chandler, AZ 85224-3171

Mailing address

1100 N Alma School Rd
Suite 7
Chandler, AZ 85224-3171
Phone (480) 855-4444

Other names 1

  • Bayshore Dental Group Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247616000000",
    "number": "1811199284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 N ALMA SCHOOL RD",
            "address_2": "SUITE 7",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852243171",
            "telephone_number": "480-855-4444",
            "fax_number": "480-857-3866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 N ALMA SCHOOL RD",
            "address_2": "SUITE 7",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852243171",
            "telephone_number": "480-855-4444",
            "fax_number": "480-857-3866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK A SHOUSHA, DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-05",
        "last_updated": "2009-07-15",
        "status": "A",
        "authorized_official_last_name": "SHOUSHA",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "ALFRED",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "480-855-4444",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "AZ",
            "license": "4329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bayshore Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2009; 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.