Individual provider Active NPI

Malcolm Lamar Shealer, DDS, MHS

  • General Practice Dentistry
  • Spring Hill, TN
National Provider Identifier
1164913760
Registry record updated Dec 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
10789 Issued in TN
Practice address
4816 Main St
Spring Hill, TN 37174-3253
Phone
(615) 610-3720
NPI assigned
May 20, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X TN
General Practice Dentistry 1223G0001X 10789 TN Primary

Addresses

Primary practice location

4816 Main St
Spring Hill, TN 37174-3253

Mailing address

815 Novalis St
Nolensville, TN 37135-1066
Phone (540) 877-7672

Other practice location 1

5110 Maryland Way
Brentwood, TN 37027-7508
Phone (615) 373-2030

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
10789TNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Affordable Dentures & Implants - Spring Hill, P.C. General Practice PastSince Jan 14, 2024 Accepting new patients
Affordable Dentures & Implants - Tennessee, PLLC General Practice Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1526774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1164913760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 NOVALIS ST",
            "city": "NOLENSVILLE",
            "state": "TN",
            "postal_code": "371351066",
            "telephone_number": "540-877-7672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4816 MAIN ST",
            "city": "SPRING HILL",
            "state": "TN",
            "postal_code": "371743253",
            "telephone_number": "615-610-3720"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5110 Maryland Way",
            "address_purpose": "LOCATION",
            "city": "Brentwood",
            "state": "TN",
            "postal_code": "370277508",
            "country_code": "US",
            "telephone_number": "615-373-2030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEALER",
        "first_name": "MALCOLM",
        "middle_name": "LAMAR",
        "name_prefix": "Dr.",
        "credential": "DDS, MHS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-20",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TN",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "10789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring Hill, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2022; 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.