Dale D. Shahan DDS LTD

Primary specialty

DentistTaxonomy code 122300000X

License

019-013067 Issued in IL

Legal business name

DALE D. SHAHAN DDS LTD

Practice address

636 Hampshire Suite 102
Quincy, IL 62301

Phone

(217) 228-0101

Fax

(217) 222-7011

NPI assigned

Sep 8, 2010

Last updated

Sep 8, 2010By 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. Dale D. Shahan, DDSNPI 1326372574

Title

Owner

Phone

(217) 228-0101

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Dale Dawson Shahan, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Quincy, IL
  • NPI 1326372574
  Authorized official Same address or phone

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

{
    "created_epoch": "1283904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283904000000",
    "number": "1114234499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "636 HAMPSHIRE SUITE 102",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "62301",
            "telephone_number": "217-228-0101",
            "fax_number": "217-222-7011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 HAMPSHIRE SUITE 102",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "62301",
            "telephone_number": "217-228-0101",
            "fax_number": "217-222-7011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DALE D. SHAHAN DDS LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-08",
        "last_updated": "2010-09-08",
        "status": "A",
        "authorized_official_last_name": "SHAHAN",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "217-228-0101",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019-013067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alaysia Nicole Culbertson, ATC
• Schvon Leigh Cummings, M.D.
• Amber Curry, FNP
• Jessica Whitney Curry, M.D.
• Custom Dental Care, P.C.
• Katie Brooke Dames
• Lauren Damon
• Alvin Joseph Gonzales Dandan, M.D.
• James M Daniels, M.D.
• Kimberly S Darnell, LCSW

• Dentist in Quincy, IL
• Providers in Quincy, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2010; 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.