Walter B. Shepherd

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

004113 Issued in NC

Legal business name

WALTER B. SHEPHERD

Practice address

113 E Moore St
Eden, NC 27288

Phone

(336) 627-5163

Fax

(336) 627-5165

NPI assigned

Mar 27, 2008

Last updated

Mar 27, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Walter B Shepherd, DDS MS PANPI 1871696427

Title

Orthodontist/Owner

Phone

(336) 627-5163

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Walter Brian Shepherd, DDS MS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Eden, NC
  • NPI 1871696427
  NPD (past) Authorized official

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

{
    "created_epoch": "1206576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206576000000",
    "number": "1295907574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 246",
            "city": "EDEN",
            "state": "NC",
            "postal_code": "272890246",
            "telephone_number": "336-627-5163",
            "fax_number": "336-627-5165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 E MOORE ST",
            "city": "EDEN",
            "state": "NC",
            "postal_code": "27288",
            "telephone_number": "336-627-5163",
            "fax_number": "336-627-5165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALTER B. SHEPHERD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-27",
        "last_updated": "2008-03-27",
        "status": "A",
        "authorized_official_last_name": "SHEPHERD",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "ORTHODONTIST/OWNER",
        "authorized_official_telephone_number": "336-627-5163",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS MS PA"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NC",
            "license": "004113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8997773",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA BCBS",
            "identifier": "078247",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Miles Scott Vonlogan, PHARMACIST
• Dhruv B Vyas, M.D.
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-1558)
• Wal-Mart Stores East, LP (Vision Center 30-1558)
• Walgreen Co (Walgreens #19513)
• Melissa Haley Walton, FNP
• Trey Washington, OTR
• Krystal Mashay Watkins
• Lauren Faith Watkins, RN, BSN
• Wescare Professional Services, LLC.

• Orthodontics and Dentofacial Orthopedics Dentistry in Eden, NC
• Providers in Eden, NC by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2008; 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.