{
"Npi": {
"NPI": "1952446148",
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"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ALAN D. SHOOPAK D.M.D. ,P.A.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "6311 4TH ST N",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ST PETERSBURG",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33702-7511",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "727-522-5599",
"MailingAddressFaxNumber": "727-526-1702",
"FirstLinePracticeLocationAddress": "8588 STARKEY RD STE C",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SEMINOLE",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33777-2831",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "727-585-6706",
"PracticeLocationAddressFaxNumber": "727-585-9359",
"EnumerationDate": "02/21/2007",
"LastUpdateDate": "04/18/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SHOOPAK",
"AuthorizedOfficialFirstName": "ALAN",
"AuthorizedOfficialMiddleName": "D",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.M.D.",
"AuthorizedOfficialTelephoneNumber": "727-522-5599",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1223X0400X",
"TaxonomyName": "Orthodontics and Dentofacial Orthopedics Dentistry",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}