John K. Shea, D.M.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

7936 Issued in TN

Practice address

131 Indian Lake Blvd
Suite 100
Hendersonville, TN 37075-6210

Phone

(615) 822-8403

Fax

(615) 822-0542

NPI assigned

Nov 19, 2005

Last updated

Jul 13, 2026By the provider in NPPES

Sex

Male

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

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Nov 10, 2022 through Nov 10, 2026

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1132358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1447232830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 INDIAN LAKE BLVD",
            "address_2": "SUITE 100",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "370756210",
            "telephone_number": "615-822-8403",
            "fax_number": "615-822-0542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 INDIAN LAKE BLVD",
            "address_2": "SUITE 100",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "370756210",
            "telephone_number": "615-822-8403",
            "fax_number": "615-822-0542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEA",
        "first_name": "JOHN",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-19",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TN",
            "license": "7936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kenneth Ryan Shaw, D.C.
• Riley Shaw, PT, DPT
• Eric Shell, PHARMD
• David R Shepherd, PHARM.D
• Reniya Shepherd
• Doreen Shewmaker, OT
• Andriah Shimer

• Oral and Maxillofacial Surgery (Dentist) in Hendersonville, TN
• Providers in Hendersonville, TN by specialty
• Oral and Maxillofacial Surgery (Dentist) in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.