Active NPI
Taylor Marie Shepherd, DMD
- Dentist
- Tipp City, OH
National Provider Identifier
1538807565
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 30.026848
- Practice address
- 110 S Tippecanoe Dr
Tipp City, OH 45371-3104 - Phone
- (937) 226-9427
- Fax
- (937) 977-1755
- NPI assigned
- May 20, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 30.026848 | OH | Primary |
Addresses
Primary practice location
110 S Tippecanoe Dr
Tipp City, OH 45371-3104
Mailing address
10135 Grover Rd
Lewisburg, OH 45338-9004
Phone (513) 939-4366
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220716000246 | OH | Order and Referring Only - Dentist | 1759762149 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30.026848 | OH | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1653004800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731456000000",
"number": "1538807565",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10135 GROVER RD",
"city": "LEWISBURG",
"state": "OH",
"postal_code": "453389004",
"telephone_number": "513-939-4366"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 S TIPPECANOE DR",
"city": "TIPP CITY",
"state": "OH",
"postal_code": "453713104",
"telephone_number": "937-226-9427",
"fax_number": "937-977-1755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEPHERD",
"first_name": "TAYLOR",
"middle_name": "MARIE",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-05-20",
"last_updated": "2024-11-13",
"certification_date": "2024-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OH",
"license": "30.026848",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tipp City, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; 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.