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General NPI Number Information
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NPI Number | 1649108093
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Entity Type | Organization
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Legal Business Name | ALAN D. SHOOPAK, D.M.D., P.A.
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Dates
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Enumeration Date | 05/13/2026
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Last Update Date | 05/13/2026
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Provider Practice Location Address
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Address Line | 10083 US HIGHWAY 19
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City | PORT RICHEY
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State | FL
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Zip | 34668-3742
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Country | US
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Telephone | 813-388-8452
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Fax | 813-315-6768
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Provider Business Mailing Address
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Address Line | 6311 4TH ST N
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City | ST PETERSBURG
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State | FL
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Zip | 33702-7511
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Country | US
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Telephone | 727-522-5599
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Fax | 813-315-6768
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Authorized Official
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Title or Position | OWNER
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Name | ALAN DAVID SHOOPAK
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Credential |
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Telephone | 727-522-5599
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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