Shawn M. Rodgers, DDS, PLLC

Primary specialty

DentistTaxonomy code 122300000X

License

24061 Issued in TX

Legal business name

SHAWN M. RODGERS, DDS, PLLC

Doing business as

Uptown Park Dental

Practice address

1121 Uptown Park Blvd Ste 19
Houston, TX 77056-3226

Phone

(713) 621-4830

Fax

(713) 621-6261

NPI assigned

Jan 13, 2015

Last updated

Jan 13, 2015By 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

Dominique D Rodgers

Title

Practice Adminstrator

Phone

(713) 621-4830

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Uptown Park Dental Doing business as

Locations

Practitioners 2

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.

• James G Moore, DDS

  • General Practice Dentistry
  • Houston, TX
  • NPI 1861699381
  NPD (past)
• Greg Richards, D.D.S.

  • General Practice Dentistry
  • Houston, TX
  • NPI 1003877697
  NPD (past)

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

{
    "created_epoch": "1421107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421107200000",
    "number": "1356730428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 UPTOWN PARK BLVD STE 19",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770563226",
            "telephone_number": "713-621-4830",
            "fax_number": "713-621-6261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 UPTOWN PARK BLVD STE 19",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770563226",
            "telephone_number": "713-621-4830",
            "fax_number": "713-621-6261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAWN M. RODGERS, DDS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-13",
        "last_updated": "2015-01-13",
        "status": "A",
        "authorized_official_last_name": "RODGERS",
        "authorized_official_first_name": "DOMINIQUE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRACTICE ADMINSTRATOR",
        "authorized_official_telephone_number": "713-621-4830"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "24061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "24061",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GENERAL DENTISTRY",
            "identifier": "1223G0001X",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Uptown Park Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Patrice Miller Shaw, DNP, APRN, FNP-C
• Tahlia Daisy Shaw, PA-C
• Taylor D Shaw, BCBA
• Theresa A H Shaw, DC
• Thomas Lashun Shaw, M.D.
• Shawn Taher DC PA
• John Shay
• Lena Alexandria Shay, MD
• Paul Luther Shay, M.D.
• Victoria Shay

• Dentist in Houston, TX
• Providers in Houston, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2015; 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.