Sheppard Dental Group LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SHEPPARD DENTAL GROUP LLC

Practice address

3051 Bay St
Lewiston, MI 49756-8855

Phone

(734) 250-1301

NPI assigned

Oct 13, 2021

Last updated

Jun 1, 2022By 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

Rebekah Kathryn Sheppard, DDSNPI 1861787350

Title

Owner

Phone

(989) 786-2104

Specialties & licenses 1

Addresses

Electronic endpoints 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Rebekah Kathryn Sheppard, D.D.S

  • General Practice Dentistry
  • Trenton, MI
  • NPI 1861787350
  NPD Authorized official
• Pamela May Braund, DMD

  • Dentist
  • Gaylord, MI
  • NPI 1134914336
  NPD (past)
• John Peter Marconnit, D.D.S.

  • Dentist
  • Lewiston, MI
  • NPI 1366631798
  NPD (past)

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

{
    "created_epoch": "1634083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654041600000",
    "number": "1073275376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 209",
            "city": "LEWISTON",
            "state": "MI",
            "postal_code": "497560209",
            "telephone_number": "989-786-2104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3051 BAY ST",
            "city": "LEWISTON",
            "state": "MI",
            "postal_code": "497568855",
            "telephone_number": "734-250-1301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHEPPARD DENTAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-13",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A",
        "authorized_official_last_name": "SHEPPARD",
        "authorized_official_first_name": "REBEKAH",
        "authorized_official_middle_name": "KATHRYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "989-786-2104",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "alpinefamilydentistry1@gmail.com",
            "affiliation": "N",
            "endpointDescription": "office website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3051 Bay St",
            "city": "Lewiston",
            "state": "MI",
            "country_code": "US",
            "postal_code": "497568855",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Hannah B Russell, PA-C
• Stephanie Rutterbush, MD
• Lisa Ann Stier, NP-C
• Thunder Bay Community Health Service, Inc (Lewiston Elementary School)
• Thunder Bay Community Health Service, Inc
• Toupin Chiropractic Clinics, P.C.
• Township of Albert (Albert Township Ambulance Service)

• Dental Clinic/Center in Lewiston, MI
• Providers in Lewiston, MI by specialty
• Dental Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2022; 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.