Individual provider Active NPI

Daniel M Sheperd, DDS

  • General Practice Dentistry
  • Montpelier, OH
National Provider Identifier
1417002619
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Practice address
904 E Snyder Ave
Montpelier, OH 43543-1276
Phone
(419) 485-3145
Fax
(419) 485-3874
NPI assigned
Jan 25, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X OH Primary

Addresses

Primary practice location

904 E Snyder Ave
Montpelier, OH 43543-1276

Mailing address

PO Box 69
Montpelier, OH 43543-0069
Phone (419) 485-3145

Other identifiers 1

IdentifierTypeStateIssuer
0525391MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20160628002400 OH Order and Referring Only - DentistPractitioner - Dentist 2365733979

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
51-7169959OHMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1417002619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 69",
            "city": "MONTPELIER",
            "state": "OH",
            "postal_code": "435430069",
            "telephone_number": "419-485-3145",
            "fax_number": "419-485-3874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 E SNYDER AVE",
            "city": "MONTPELIER",
            "state": "OH",
            "postal_code": "435431276",
            "telephone_number": "419-485-3145",
            "fax_number": "419-485-3874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPERD",
        "first_name": "DANIEL",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0525391",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montpelier, OH

Sources for this page

Verify at the official NPI Registry.