Individual provider Active NPI

Gary Howard Shanker, D.D.S

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Saint Louis, MO
National Provider Identifier
1063498020
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
000363 Issued in MO
Practice address
12111 Tesson Ferry Professional Ctr
Saint Louis, MO 63128-1250
Phone
(314) 842-4105
Fax
(314) 842-3580
NPI assigned
Dec 21, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 000363 MO Primary

Addresses

Primary practice location

12111 Tesson Ferry Professional Ctr
Saint Louis, MO 63128-1250

Mailing address

12111 Tesson Ferry Professional Ctr
Saint Louis, MO 63128-1250
Phone (314) 842-4105

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jonathan a Shanker DDS Ms & Brian a Schlueter DMD Ms PC Orthodontics and Dentofacial Orthopedics Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1135123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1063498020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12111 TESSON FERRY PROFESSIONAL CTR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631281250",
            "telephone_number": "314-842-4105",
            "fax_number": "314-842-3580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12111 TESSON FERRY PROFESSIONAL CTR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631281250",
            "telephone_number": "314-842-4105",
            "fax_number": "314-842-3580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANKER",
        "first_name": "GARY",
        "middle_name": "HOWARD",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-21",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MO",
            "license": "000363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.