Brian C Shepanski, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DS037332 Issued in PA

Practice address

601 Williamsburg Dr
Broomall, PA 19008-3428

Phone

(610) 353-2700

Fax

(610) 353-5528

NPI assigned

Oct 10, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Williamsburg Dental of Pennsylvania, P.C.

  • General Practice Dentistry
  • Broomall, PA
  • NPI 1558171876
  NPD (past)
• Williamsburg Dental, P.C.

  • General Practice Dentistry
  • Broomall, PA
  • NPI 1942418363
  NPD (past)

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

{
    "created_epoch": "1191974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191974400000",
    "number": "1194913640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 TEMPLE RD",
            "city": "GLEN MILLS",
            "state": "PA",
            "postal_code": "193422263",
            "telephone_number": "610-459-3078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 WILLIAMSBURG DR",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190083428",
            "telephone_number": "610-353-2700",
            "fax_number": "610-353-5528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPANSKI",
        "first_name": "BRIAN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-10",
        "last_updated": "2007-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS037332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Senior Care Centers of Pennsylvania, Inc.
• Senior Care Centers of Pennsylvania, Inc.
• Seth M. Blitzer, DMD, PC
• Erin Shappelle
• Zufang Sheng, L.AC.
• Sheridan Ventures, Inc.
• Rachel Shimko, DPT
• Stephen A Shore, M.D.
• Andrew Edward Short, MD
• Lori Short, BCBA

• Dentist in Broomall, PA
• Providers in Broomall, PA by specialty
• Dentist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.