Christopher B Shumway, DDS
Individual provider Active NPI Dentist · Slinger, WI
NPI 1174623375 · NPPES record last updated Jul 22, 2008
Key facts
- NPI
- 1174623375
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 5724-015 (WI)
- Practice address
- 100 E Commerce Blvd
Suite B
Slinger, WI 53086-9748 - Phone
- (262) 644-7400
- NPI assigned
- Sep 25, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160108001375 | WI | Order and Referring Only - Dentist |
3173825031 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 5724-015 | WI | Yes |
Addresses
Primary practice location
100 E Commerce Blvd
Suite B
Slinger, WI 53086-9748
Mailing address
100 E Commerce Blvd
Suite B
Slinger, WI 53086-9748
Phone (262) 644-7400
Other providers in Slinger, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 22, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.