Ty Shafer DDS PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

21301 Issued in TX

Legal business name

TY SHAFER DDS PA

Doing business as

Shafer Dental

Practice address

311 W. Southlake Blvd.
Suite 100
Southlake, TX 76092

Phone

(817) 416-2228

Fax

(817) 421-0408

NPI assigned

Sep 15, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Ty Shafer, D.D.S

Title

Owner

Phone

(817) 416-2228

Specialties & licenses 1

Addresses

Other names 1

• Shafer Dental Doing business as

Tax ID family

Shafer Dental2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Ty Shafer DDS PA

  • General Practice Dentistry
  • Southlake, TX
  • NPI 1457502429
  NPD tax ID

Locations

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

{
    "created_epoch": "1316044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316044800000",
    "number": "1316229271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 W. SOUTHLAKE BLVD.",
            "address_2": "SUITE 100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "76092",
            "telephone_number": "817-416-2228",
            "fax_number": "817-421-0408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 W. SOUTHLAKE BLVD.",
            "address_2": "SUITE 100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "76092",
            "telephone_number": "817-416-2228",
            "fax_number": "817-421-0408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TY SHAFER DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-15",
        "last_updated": "2011-09-15",
        "status": "A",
        "authorized_official_last_name": "SHAFER",
        "authorized_official_first_name": "TY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-416-2228",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "21301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shafer Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Abigail Turley
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• TX Ortho Neuro Institute PLLC
• Ty Shafer DDS PA
• U S Anesthesia Partners of Texas, PA
• Rhia Ubeda, PT
• University Counseling, PLLC
• University of Texas Southwestern Medical Center at Dallas

• General Practice Dentistry in Southlake, TX
• Providers in Southlake, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2011; 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.