Katherine Shackleford, D.D.S

Primary specialty

DentistTaxonomy code 122300000X

License

2901018626 Issued in MI

Practice address

1359 Champaign Rd
Lincoln Park, MI 48146-3303

Phone

(313) 386-9660

NPI assigned

Mar 27, 2013

Last updated

Jun 8, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Galayda & Shackleford DDS PC

  dba The Dental Clinic

  • General Practice Dentistry
  • Lincoln Park, MI
  • NPI 1265975551
  NPD (past) Authorized official
• The Dental Clinic PC

  • General Practice Dentistry
  • Lincoln Park, MI
  • NPI 1003929662
  NPD (past)

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

{
    "created_epoch": "1364342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433721600000",
    "number": "1336481431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1359 CHAMPAIGN RD",
            "city": "LINCOLN PARK",
            "state": "MI",
            "postal_code": "481463303",
            "telephone_number": "313-386-9660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1359 CHAMPAIGN RD",
            "city": "LINCOLN PARK",
            "state": "MI",
            "postal_code": "481463303",
            "telephone_number": "313-386-9660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHACKLEFORD",
        "first_name": "KATHERINE",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-27",
        "last_updated": "2015-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901018626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca J Schwarcz, DDS
• Paul George Sciole, LLMSW
• Hassan Sebai
• Senior Home Care Connections LLC
• Robert C Seski, MD
• Kartik H Shah, M.D.
• Shashi K Malik, MD, PC
• Margaret Sheehan
• Hassan M Shehadi, PHARMD
• Hannah Jane Sheppard

• Dentist in Lincoln Park, MI
• Providers in Lincoln Park, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.