Individual provider Active NPI

Wesley E. Shankland II, D.D.S., PH.D.

  • Dentist
  • Westerville, OH
National Provider Identifier
1417006891
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
15798 Issued in OH
Practice address
158 Commerce Park Dr # a
Westerville, OH 43082-7935
Phone
(614) 794-0033
Fax
(614) 794-2291
NPI assigned
Jan 9, 2007
Last updated
Jul 9, 2007By the provider in NPPES
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
Dentist 122300000X 15798 OH Primary

Addresses

Primary practice location

158 Commerce Park Dr # a
Westerville, OH 43082-7935

Mailing address

158 Commerce Park Dr # a
Westerville, OH 43082-7935
Phone (614) 794-0033

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jun 17, 2015 through Jun 17, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
15798OHMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Lima Oral Sleep Center-Risolvato, LLC. Current Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1417006891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "158 COMMERCE PARK DR # A",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430827935",
            "telephone_number": "614-794-0033",
            "fax_number": "614-794-2291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "158 COMMERCE PARK DR # A",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430827935",
            "telephone_number": "614-794-0033",
            "fax_number": "614-794-2291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANKLAND",
        "first_name": "WESLEY",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "D.D.S., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "15798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westerville, OH

Sources for this page

Verify at the official NPI Registry.