SHORES DENTAL PLLC (NPI# 1720528599) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720528599 |
| Entity Type | Organization |
| Organization Name | SHORES DENTAL PLLC |
| Practice Address |
28503 Little Mack Ave Saint Clair Shores MI 48081-1119 |
| Mailing Address |
350 Pine Ridge Dr Bloomfield Hills MI 48304-2139 |
| Practice Telephone | 2487711990 |
| Mailing Telephone | 2489311151 |
| Enumeration Date | 2017-02-27 |
| Last Update Date | 2017-02-27 |
| Authorized Official Name | DR. RANDALL SHAW (MANAGER) |
| Authorized Official Telephone | 2489311151 |
| Authorized Official Credential | DDS, MS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 13819 | MI | Dental Providers |
| Street Address |
28503 LITTLE MACK AVE |
| City | SAINT CLAIR SHORES |
| State | MI |
| Zip Code | 48081-1119 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427015692 | Gust Dino Tolias | Dentist | 28503 Little Mack Ave, Saint Clair Shores, MI 48081-1119 | 2006-04-29 |
| 1174789341 | Donald Brosky | Dentist | 28503 Little Mack Ave, Saint Clair Shores, MI 48081-1119 | 2008-08-06 |
| 1952405169 | G. Dino Tolias,d.d.s. P.C. | Dentist | 28503 Little Mack Ave, Saint Clair Shores, MI 48081-1119 | 2006-09-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750865416 | Saint Clair Family Pharmacy LLC | Pharmacy | 28001 Harper Ave., Saint Clair Shores, MI 48081 | 2018-09-19 |
| 1669995783 | Terra Laquay Ginther | Social Worker | 28800 Harper Ave Ste A, Saint Clair Shores, MI 48081 | 2017-07-20 |
| 1245676998 | Julia Hanson | Social Worker | 27941 Harper Ave., Suite 105, St. Clair Shores, MI 48081 | 2013-05-21 |
| 1760731301 | Life Transition Service | Community/Behavioral Health | 21031 Sunnydale, St. Clair Shore, MI 48081 | 2012-08-29 |
| 1477868792 | William Burr Wood | Pharmacist | 21000 Twelve Milerd., St Clair Shores, MI 48081 | 2010-08-11 |
| 1508094350 | Dominic Anthony Garrisi | Anesthesiology | 21018 Bon Brae, St. Clair Shores, MI 48081 | 2009-06-30 |
| 1992947022 | Karen Ostrowski-thomas | Occupational Therapist | 22442 Bayview, St. Clair Shores, MI 48081 | 2009-04-06 |
| 1891979787 | Chirag Rachhadia | Physical Therapist | 29150 Harper Avenue, St. Clair Shores, MI 48081 | 2007-12-27 |
| 1598955114 | Donna Warner Manczak | Psychologist | 21400 E Eleven Mil Rd, St Clair Shores, MI 48081 | 2007-07-30 |
| 1467652347 | Sumit Narayanprasad Fogla | Family Medicine | 21400 E Eleven Mile Road, St. Clair Shores, MI 48081 | 2007-07-19 |
| Find all providers in zip 48081 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144835059 | Chelsea Anthony | Dentist | 23207 Norcrest Dr, Saint Clair Shores, MI 48080-2586 | 2020-09-09 |
| 1194134999 | Kefei Duan | Dentist | 26210 Harper Ave # 100, Saint Clair Shores, MI 48081-2203 | 2014-08-05 |
| 1649457078 | Leonard Yee Wong | Dentist | 22301 Mack Ave, Saint Clair Shores, MI 48080-2376 | 2008-01-29 |
| 1063609220 | Shoreline Dental Center | Dentist | 31118 Harper Ave, Saint Clair Shores, MI 48082-1950 | 2007-10-01 |
| 1619178886 | Cynthia E. Paquette | Dentist | 20609 E 11 Mile Rd, Saint Clair Shores, MI 48081-1401 | 2007-05-29 |
| 1023236841 | Raminta Mastis | Dentist | 22621 Harper Ave, Saint Clair Shores, MI 48080-1821 | 2007-04-24 |
| 1760512339 | William Brownscombe | Dentist | 24055 Jefferson Ave, Suite 210, Saint Clair Shores, MI 48080-1511 | 2007-03-06 |
| 1427126457 | Daniel M Hull | Dentist | 31549 Harper, Saint Clair Shores, MI 48082 | 2006-11-30 |
| 1447326012 | Ray Anthony Najarro Ascano | Dentist | 26210 Harper Ave, Saint Clair Shores, MI 48081-2203 | 2006-11-27 |
| 1952417784 | Jehan Wakeem | Dentist | 28130 Harper Avenue, Saint Clair Shores, MI 48081 | 2006-08-22 |
| Find all providers in SAINT CLAIR SHORES | ||||
| City | SAINT CLAIR SHORES |
| Zip Code | 48081 |
Please comment or provide details below to improve the information on SHORES DENTAL PLLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.