SHORELINE ANESTHESIA, LLC
NPI 1407445620
Dentist - Dentist Anesthesiologist in Kokomo, IN

Active since January 12, 2021
101 N UNION ST UNIT 533, KOKOMO, IN 46901(718) 644-0622 Get Directions Write a Review

NPPES record last updated: January 12, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Shoreline Anesthesia, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHORELINE ANESTHESIA, LLC (NPI 1407445620) is a healthcare organization registered as a dentist anesthesiologist in Kokomo, Indiana and active in the NPI registry since January 2021. The organization lists Thomas John Schaffer, President, as its authorized official.

NPPES Registry Identity

NPI1407445620
Entity TypeOrganization
Primary Taxonomy1223D0004X
Legal Business NameSHORELINE ANESTHESIA, LLC
Location Address101 N UNION ST UNIT 533Kokomo, IN 46901-5045
Mailing Address101 N Union St Unit 533Kokomo, IN 46901-5045 · (718) 644-0622
Organization SubpartNo
Authorized OfficialThomas John SchafferPresident · (718) 644-0622
Enumeration DateJanuary 12, 2021
NPPES CertifiedJanuary 12, 2021
NPI 1407445620 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · Dentist AnesthesiologistDental Providers
Taxonomy Code1223D0004X
Definition

A dentist who has successfully completed an accredited postdoctoral anesthesiology residency training program for dentists of two or more years duration, in accord with Commission on Dental Accreditation's Standards for Dental Anesthesiology Residency Programs, and/or meets the eligibility requirements for examination by the American Dental Board of Anesthesiology.

101 N UNION ST UNIT 533, Kokomo, IN 46901

Other Identifiers 1

Medicaid1780052936MP

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1407445620, enumerated as an "organization" on January 12, 2021.

The provider is located at 101 N UNION ST UNIT 533 KOKOMO, IN 46901 and the phone number is (718) 644-0622.

Dentist with taxonomy code 1223D0004X and a focus in Dentist Anesthesiologist.

The provider might be accepting Accepts: DentaQuest USA Insurance, Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.