James a Shupe DDS, Dentistry for Children, Inc

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

54000026A Issued in IN

Legal business name

JAMES A SHUPE DDS, DENTISTRY FOR CHILDREN, INC

Practice address

3030 Lake Ave
Suite 15
Fort Wayne, IN 46805-5428

Phone

(260) 422-8419

Fax

(260) 422-3591

NPI assigned

Sep 21, 2006

Organization subpart

No

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

Authorized official

Name

James A Shupe Jr., DDS

Title

President

Phone

(260) 422-8419

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124127832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 LAKE AVE",
            "address_2": "SUITE 15",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468055428",
            "telephone_number": "260-422-8419",
            "fax_number": "260-422-3591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 LAKE AVE",
            "address_2": "SUITE 15",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468055428",
            "telephone_number": "260-422-8419",
            "fax_number": "260-422-3591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES A SHUPE DDS, DENTISTRY FOR CHILDREN, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHUPE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "260-422-8419",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IN",
            "license": "54000026A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sushil K. Jain, MD
• Swarn Shubbi Jain, LMHC
• Suresh Jaiswal, M.D.
• Peter A. Jakacki, MD
• Zachary Jakubik, DO
• James a. Long, II O.D. Inc
• James C Ransbottom, M.D.
• James E. Dumas, DDS, PC
• James H Pennington OD
• James Medical Rents & Sales, Inc.

• Pediatric Dentistry in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Pediatric 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.