Jason E Shockley Ms, DDS, PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

DEN.00203594 Issued in CO

Legal business name

JASON E SHOCKLEY MS, DDS, PLLC

Doing business as

Yampa Valley Family Dentistry

Practice address

580 Pershing St
Craig, CO 81625-3047

Phone

(970) 824-9785

Fax

(970) 824-2215

NPI assigned

Jun 19, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Jason E Shockley, MS, DDSNPI 1255823688

Title

Doctor

Phone

(970) 824-9785

Specialties & licenses 1

Addresses

Other names 1

• Yampa Valley Family Dentistry Doing business as

Practitioners 2

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.

• Jason Edward Shockley, MS, DDS

  • Dentist
  • Craig, CO
  • NPI 1255823688
  NPD (past) Authorized official
• Neal L Fenton, DDS

  • Dentist
  • Craig, CO
  • NPI 1295735546
  NPD (past)

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

{
    "created_epoch": "1529366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529366400000",
    "number": "1134613565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "580 PERSHING ST",
            "city": "CRAIG",
            "state": "CO",
            "postal_code": "816253047",
            "telephone_number": "970-761-3365",
            "fax_number": "970-824-2215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 PERSHING ST",
            "city": "CRAIG",
            "state": "CO",
            "postal_code": "816253047",
            "telephone_number": "970-824-9785",
            "fax_number": "970-824-2215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JASON E SHOCKLEY MS, DDS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-19",
        "last_updated": "2018-06-19",
        "status": "A",
        "authorized_official_last_name": "SHOCKLEY",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "970-824-9785",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MS, DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CO",
            "license": "DEN.00203594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Yampa Valley Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Intermountain Medical Group Grand Junction, LLC (Craig Neurosurgery Outreach Clinic)
• Nadia Sky Iovettz-Tereshchenko, M.D.
• Ann T Irvin, RN BSN
• Ivy Psychotherapies LLC
• David Robert James, MD
• Frances Mary Jenkins, PA
• Malea Johnson, RDH, EPDH
• Jean Carol Jones, RN
• Annie Juergens, RDH
• Karla Persichitte LPC LLC

• Dental Clinic/Center in Craig, CO
• Providers in Craig, CO by specialty
• Dental Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2018; 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.