John C. Shepard, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3594 Issued in LA

Practice address

113 Professional Dr
West Monroe, LA 71291-5331

Phone

(318) 325-5423

Fax

(318) 387-7080

NPI assigned

Aug 21, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Matthew H Thornhill LLC

  • Dental Clinic/Center
  • West Monroe, LA
  • NPI 1053004408
  NPD (past)

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243382400000",
    "number": "1265548747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 PROFESSIONAL DR",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712915331",
            "telephone_number": "318-325-5423",
            "fax_number": "318-387-7080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 PROFESSIONAL DR",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712915331",
            "telephone_number": "318-325-5423",
            "fax_number": "318-387-7080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPARD",
        "first_name": "JOHN",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2009-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "3594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1835943",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "720920909",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Bamburg Sharp, F.N.P.
• Lezlee Shauf, SLP
• Shelby House LLC
• Debra A. Shelton, NP
• Tom Reese Shelton Jr., RPH
• Matthew Sherlock, RPH
• Rebecca Elizabeth Sherwin, PT
• Todd Philip Sherwin, LPC LMFT
• Troy Channing Shows, O.T.
• Jamie Sikes, MOT

• General Practice Dentistry in West Monroe, LA
• Providers in West Monroe, LA by specialty
• General Practice Dentistry in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2009; 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.