John M. Shader DMD, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D6442 Issued in OR

Legal business name

JOHN M. SHADER DMD, PC

Practice address

100 E Oak St
Lebanon, OR 97355-4135

Phone

(541) 451-1176

Fax

(541) 451-1424

NPI assigned

Jun 16, 2009

Organization subpart

No

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

Authorized official

Name

Mrs. Patricia Clare Shader

Title

Office Manager/ Owner

Phone

(541) 451-1176

Specialties & licenses 1

Addresses

Other names 1

• John M. Shader, DMD Former legal business name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Geoffrey W Blatter, DMD

  • Dentist
  • Lebanon, OR
  • NPI 1326470386
  NPD (past)

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

{
    "created_epoch": "1245110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245110400000",
    "number": "1356578421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E OAK ST",
            "city": "LEBANON",
            "state": "OR",
            "postal_code": "973554135",
            "telephone_number": "541-451-1176",
            "fax_number": "541-451-1424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E OAK ST",
            "city": "LEBANON",
            "state": "OR",
            "postal_code": "973554135",
            "telephone_number": "541-451-1176",
            "fax_number": "541-451-1424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN M. SHADER DMD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-16",
        "last_updated": "2009-06-16",
        "status": "A",
        "authorized_official_last_name": "SHADER",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "CLARE",
        "authorized_official_title_or_position": "OFFICE MANAGER/ OWNER",
        "authorized_official_telephone_number": "541-451-1176",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D6442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "John M. Shader, DMD",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Hannah M James, LMT
• Dante Jaramillo
• David John Jeffries
• Emily Anne Jenkins, M.A.
• Alyssa Jensen, RT(R)
• C Ben Johnson, PA-C
• Cailin Johnson
• Chase Alexander Johnson
• Tyler Kenneth Johnson, DO
• Karen Ann Johnston, RPH

• General Practice Dentistry in Lebanon, OR
• Providers in Lebanon, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.