Shane A Fisher, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DN29834 Issued in FL

Practice address

819 NE 26TH St
Wilton Manors, FL 33305-1239

Phone

(954) 564-5540

NPI assigned

Oct 24, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1285624171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2132 NW 5TH AVE",
            "city": "WILTON MANORS",
            "state": "FL",
            "postal_code": "333113702",
            "telephone_number": "773-577-7667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "819 NE 26TH ST",
            "city": "WILTON MANORS",
            "state": "FL",
            "postal_code": "333051239",
            "telephone_number": "954-564-5540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "SHANE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-24",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019-025019",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IL",
            "license": "025-001997",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WI",
            "license": "5127015",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "FL",
            "license": "DN29834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Andrew Farris, PSY.D.
• Felice Fusca LCSW LLC
• Ferdinand Cabrera MD PA
• Arielvys Fernandez Febles, RDH
• Robert John Ferraiuolo, LMHC
• Florida Institute for Recovery and Sex Therapy
• Florida Institute of Health LTD LLLP
• Fort Lauderdale Couples, Family & Individual Therapy
• Fort Lauderdale Couples, Family and Individual Therapy, LLC
• Fort Lauderdale Medical Surgical Associates., Inc.

• Pediatric Dentistry in Wilton Manors, FL
• Providers in Wilton Manors, FL by specialty
• Pediatric Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2025; 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.