Shelburne Dental Services, P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

016-60069455 Issued in VT

Legal business name

SHELBURNE DENTAL SERVICES, P.C.

Doing business as

Shelburne Dental Group

Practice address

30 Shelburne Shopping Park
Shelburne, VT 05482-7488

Phone

(802) 985-3500

Fax

(802) 985-2979

NPI assigned

Jul 3, 2013

Last updated

Jul 3, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Nathan Bouchard, DDS

Title

Owner/Dentist

Phone

(603) 320-4994

Specialties & licenses 1

Addresses

Other names 1

• Shelburne Dental Group Doing business as

Locations

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

{
    "created_epoch": "1372809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372809600000",
    "number": "1053751164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "267 PEARL ST UNIT B1",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054018543",
            "telephone_number": "603-320-4994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 SHELBURNE SHOPPING PARK",
            "city": "SHELBURNE",
            "state": "VT",
            "postal_code": "054827488",
            "telephone_number": "802-985-3500",
            "fax_number": "802-985-2979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHELBURNE DENTAL SERVICES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-03",
        "last_updated": "2013-07-03",
        "status": "A",
        "authorized_official_last_name": "BOUCHARD",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "603-320-4994",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VT",
            "license": "016-60069455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shelburne Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jillan Cantor Sackett, M.D., M.S.
• Bernard Guy Sage
• Kathleen Sawtelle, PHARM D, RPH
• Elizabeth Anne Scheuerman, L.AC.,L.H.,DIPL.OM
• Igor N Schwartzman, ND
• Shelburne Medical Supplies
• Shelburne Pediatrics
• Shelburne Restorative Dentistry
• Susan Shull, M.D., PH.D.
• Evelyn M Smith, MA LCMHC

• General Practice Dentistry in Shelburne, VT
• Providers in Shelburne, VT by specialty
• General Practice Dentistry in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2013; 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.