Individual provider Active NPI

Mandy Louise Shearer, D.D.S.

  • Dentist
  • Soddy Daisy, TN
National Provider Identifier
1073724944
Registry record updated Aug 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
8576 Issued in TN
Practice address
9759 Dayton Pike
Soddy Daisy, TN 37379-4729
Phone
(423) 332-5275
NPI assigned
May 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 8576 TN Primary

Addresses

Primary practice location

9759 Dayton Pike
Soddy Daisy, TN 37379-4729

Mailing address

9759 Dayton Pike
Soddy Daisy, TN 37379-4729
Phone (423) 332-5275

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150429002321 TN Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 1456670207

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8576TNMDMental Health Counselor
54711CAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786406400000",
    "number": "1073724944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9759 DAYTON PIKE",
            "city": "SODDY DAISY",
            "state": "TN",
            "postal_code": "373794729",
            "telephone_number": "423-332-5275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9759 DAYTON PIKE",
            "city": "SODDY DAISY",
            "state": "TN",
            "postal_code": "373794729",
            "telephone_number": "423-332-5275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEARER",
        "first_name": "MANDY",
        "middle_name": "LOUISE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-24",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "8576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Soddy Daisy, TN

Sources for this page

Verify at the official NPI Registry.