NPIMap

Organization Active NPI

Affiliated Dental Specialist PL

  • General Practice Dentistry
  • St Petersburg, FL
National Provider Identifier
1972057875
Registry record updated Nov 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
AFFILIATED DENTAL SPECIALIST PL
Practice address
6311 4TH St N
St Petersburg, FL 33702-7511
Phone
(727) 474-0317
Fax
(727) 526-1702
NPI assigned
Aug 9, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2017

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

Authorized official

Name
Alan Shoopak, DMD
Title
Orthodontist
Phone
(727) 474-0317

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

6311 4TH St N
St Petersburg, FL 33702-7511

Mailing address

6311 4TH St N
St Petersburg, FL 33702-7511
Phone (727) 474-0317

Other names 1

  • Dental Specialists of Florida Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Afilliated Dental Specialist PL11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

NPI Registry JSON

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

{
    "created_epoch": "1470700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510790400000",
    "number": "1972057875",
    "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": "727-474-0317",
            "fax_number": "727-526-1702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6311 4TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337027511",
            "telephone_number": "727-474-0317",
            "fax_number": "727-526-1702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFILIATED DENTAL SPECIALIST PL",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-09",
        "last_updated": "2017-11-16",
        "status": "A",
        "authorized_official_last_name": "SHOOPAK",
        "authorized_official_first_name": "ALAN",
        "authorized_official_title_or_position": "ORTHODONTIST",
        "authorized_official_telephone_number": "727-474-0317",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Specialists of Florida",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 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.