Mark Alfred Shousha, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

4329 Issued in AZ

Practice address

1100 N Alma School Rd Ste 7
Chandler, AZ 85224-3169

Phone

(602) 819-2036

Fax

(480) 857-3866

NPI assigned

Dec 6, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

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

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.

• Mark a Shousha, DDS PC

  dba Bayshore Dental Group

  • Dentist
  • Chandler, AZ
  • NPI 1811199284
  NPD (past) Authorized official
• L. Morse, DMD, P.C.

  dba Bayshore Dental Group

  • Dental Clinic/Center
  • Chandler, AZ
  • NPI 1952846297
  NPD (past)

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683072000000",
    "number": "1841274487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7510",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852467510",
            "telephone_number": "602-819-2036",
            "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 STE 7",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852243169",
            "telephone_number": "602-819-2036",
            "fax_number": "480-857-3866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOUSHA",
        "first_name": "MARK",
        "middle_name": "ALFRED",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-06",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "4329",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122656",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Margery Amy Anne Shoptaugh, MD
• Cassandra Lynne Shore, P.A.
• Shoreline Counseling LLC
• Jack Henry Short, M.D.
• Savannah Rose Short
• Nickolena Showers
• Muath Shqeirat, PHARMD
• Shreya Health of Arizona, Inc
• Lindsay Ann Shroyer, AUD
• Mikhail I Shtivelband, MD

• Dentist in Chandler, AZ
• Providers in Chandler, AZ by specialty
• Dentist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2023; 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.