Family Dental Care, Chad Shaw D.D.S.,P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12010465A Issued in IN

Legal business name

FAMILY DENTAL CARE, CHAD SHAW D.D.S.,P.C.

Practice address

1409 N Michigan St
Plymouth, IN 46563-1119

Phone

(574) 936-8787

NPI assigned

Mar 16, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Chad J. Shaw, D.D.S.

Title

President

Phone

(574) 936-8787

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104950492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1409 N MICHIGAN ST",
            "city": "PLYMOUTH",
            "state": "IN",
            "postal_code": "465631119",
            "telephone_number": "574-936-8787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 N MICHIGAN ST",
            "city": "PLYMOUTH",
            "state": "IN",
            "postal_code": "465631119",
            "telephone_number": "574-936-8787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY DENTAL CARE, CHAD SHAW D.D.S.,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "CHAD",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "574-936-8787",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12010465A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna Michelle Eggers, MCD CCCSLP
• Glenda Ensweiler, NP
• Eric Foster, Inc.
• Monica Esquivel, R.D.
• Jacqueline Ann Eveland, N.P.
• Family Medicine Center of Plymouth PC
• Donald Joseph Faulkner, M.D.
• Mariel Regina Feeks, PHARMD
• Travis Paul Fernandez, RPH
• FH Decks and Landscaping Inc

• General Practice Dentistry in Plymouth, IN
• Providers in Plymouth, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.