Shawn M Custer Dental PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SHAWN M CUSTER DENTAL PLLC

Doing business as

Park View Family Dental Ft. Collins

Practice address

3950 John F Kennedy Pkwy Unit E
Fort Collins, CO 80525-3074

Phone

(970) 732-4371

NPI assigned

Jan 19, 2022

Organization subpart

Yes

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

Authorized official

Name

Shawn Michael CusterNPI 1801324298

Title

Owner

Phone

(402) 721-8200

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Park View Family Dental Ft. Collins Doing business as

Electronic endpoints 1

Part of

Shawn M Custer Dental PLLC

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shawn Michael Custer, DDS

  • General Practice Dentistry
  • Greeley, CO
  • NPI 1801324298
  NPD Authorized official

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

{
    "created_epoch": "1642550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642550400000",
    "number": "1255083473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3950 JOHN F KENNEDY PKWY UNIT E",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805253074",
            "telephone_number": "970-732-4371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 JOHN F KENNEDY PKWY UNIT E",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805253074",
            "telephone_number": "970-732-4371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAWN M CUSTER DENTAL PLLC",
        "organizational_subpart": "YES",
        "enumeration_date": "2022-01-19",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A",
        "authorized_official_last_name": "CUSTER",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "402-721-8200"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000154967",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sarah@parkviewfamilydentistry.net",
            "affiliation": "N",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3950 John F Kennedy Pkwy Unit E",
            "city": "Fort Collins",
            "state": "CO",
            "country_code": "US",
            "postal_code": "805253074",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Park View Family Dental Ft. Collins",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ry Shavlik
• Shaw Family Practice PC
• Ashley R Shaw, MA
• Desiree M Shaw, PT, MPT
• Madeline Shaw, RBT
• Bonnie Shea, DPT
• Mike Shea, RD
• Wendy C Sheaffer
• Dan James Shearer, MS, LMFT
• Catherine Clare Sheedy, M.S. CCC-SLP

• Dental Clinic/Center in Fort Collins, CO
• Providers in Fort Collins, 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 Jan 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.