Active NPI
Craig James Shepherd, D.M.D.
- Dental Anesthesiology
- Wexford, PA
National Provider Identifier
1124018619
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Anesthesiology
- License
- DS031543L
- Practice address
- 156 Blue Heron Dr
Wexford, PA 15090-2514 - Phone
- (724) 759-7948
- Fax
- (724) 759-7952
- NPI assigned
- Oct 25, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Anesthesiology | 1223D0004X | DS031543L | PA | Primary |
Addresses
Primary practice location
156 Blue Heron Dr
Wexford, PA 15090-2514
Mailing address
156 Blue Heron Dr
Wexford, PA 15090-2514
Phone (724) 759-7948
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS031543L | PA | MD | Dentist Anesthesiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Dental Health Services, Inc. | 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 and National Provider Directory roles.
-
- General Practice Dentistry
- Pittsburgh, PA
- NPI 1194788653
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130198400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707350400000",
"number": "1124018619",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "156 BLUE HERON DR",
"city": "WEXFORD",
"state": "PA",
"postal_code": "150902514",
"telephone_number": "724-759-7948",
"fax_number": "724-759-7952"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "156 BLUE HERON DR",
"city": "WEXFORD",
"state": "PA",
"postal_code": "150902514",
"telephone_number": "724-759-7948",
"fax_number": "724-759-7952"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEPHERD",
"first_name": "CRAIG",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-10-25",
"last_updated": "2024-02-08",
"certification_date": "2024-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223D0004X",
"taxonomy_group": "",
"desc": "Dentist, Dental Anesthesiology",
"state": "PA",
"license": "DS031543L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wexford, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.