Keith L Sheppard, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

63827 Issued in CA

Practice address

11300 Pleasant Valley Rd
Penn Valley, CA 95946-9026

Phone

(530) 432-1543

Fax

(530) 432-1543

NPI assigned

Aug 7, 2014

Last updated

Mar 17, 2018By 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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1407369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1497164008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11300 PLEASANT VALLEY RD",
            "city": "PENN VALLEY",
            "state": "CA",
            "postal_code": "959469026",
            "telephone_number": "530-432-1543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11300 PLEASANT VALLEY RD",
            "city": "PENN VALLEY",
            "state": "CA",
            "postal_code": "959469026",
            "telephone_number": "530-432-1543",
            "fax_number": "530-432-1543"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13945 Mono Way",
            "address_purpose": "LOCATION",
            "city": "Sonora",
            "state": "CA",
            "postal_code": "953702823",
            "country_code": "US",
            "telephone_number": "209-533-9630",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEPPARD",
        "first_name": "KEITH",
        "middle_name": "L",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-07",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "63827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Penn Valley Union Elementary School District
• David Peterson, D.C.
• Morgan Plumb
• Karen M Rinkleib, D.C.
• Brittany Roussel, DOULA
• Sierra Nevada Primary Care
• Monte John Smith, DDS
• Shaunee Jolenne Steel, LVN
• Doug Stone, NP
• Belinda Stroud, PSY.D.

• General Practice Dentistry in Penn Valley, CA
• Providers in Penn Valley, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.