Shane Mathew Thomas, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

2901021955 Issued in MI

Practice address

15055 22 Mile Rd Ste 200
Shelby Township, MI 48315-4401

Phone

(586) 247-3500

NPI assigned

Jun 27, 2016

Last updated

Sep 26, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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 MI

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

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• James E Mikula DDS PC

  • General Practice Dentistry
  • Livonia, MI
  • NPI 1265716724
  NPD (past)
• Seva Dental Michigan PC

  dba Livonia Dental Team

  • Dentist
  • Livonia, MI
  • NPI 1124882089
  NPD (past)

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

{
    "created_epoch": "1466985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1225489735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 MAPLERIDGE RD",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483092747",
            "telephone_number": "586-925-1346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15055 22 MILE RD STE 200",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483154401",
            "telephone_number": "586-247-3500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15875 Middlebelt Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Livonia",
            "state": "MI",
            "postal_code": "481543885",
            "country_code": "US",
            "telephone_number": "734-427-9871",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "SHANE",
        "middle_name": "MATHEW",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-27",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901021955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Solution to Life
• Theramax
• Daija Theus
• Betsy Thomas, FNP
• Kearston Thomas
• Suresh Zachariah Thomas, P.T.
• Carol-Ann Thompson
• Heather N Thompson
• Octavia Nekala Thompson
• Natalie Thorson

• Dentist in Shelby Township, MI
• Providers in Shelby Township, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2023; 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.