NPIMap

Organization Active NPI

Michael W. Shenk D.D.S. P.C.

Doing business as Shenk Dental Care

  • General Practice Dentistry
  • Roswell, GA
National Provider Identifier
1619074291
Registry record updated Mar 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN014141 Issued in GA
Legal business name
MICHAEL W. SHENK D.D.S. P.C.
Doing business as
Shenk Dental Care
Practice address
4690 Woodstock Rd
Suite 100
Roswell, GA 30075-1678
Phone
(770) 992-6568
Fax
(770) 992-9520
NPI assigned
Sep 17, 2006
Last updated
Mar 26, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2013

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

Authorized official

Name
Dr. Judd W. Shenk, D.M.D..NPI 1841503737
Title
President
Phone
(770) 992-6568

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN014141 GA Primary

Addresses

Primary practice location

4690 Woodstock Rd
Suite 100
Roswell, GA 30075-1678

Mailing address

4690 Woodstock Rd
Suite 100
Roswell, GA 30075-1678
Phone (770) 992-6568

Other names 1

  • Shenk Dental Care Doing business as

National Provider Directory

National Provider Directory

Locations

4690 Woodstock Rd
Ste 100
Roswell, GA 30075
Phone (770) 992-6568

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364256000000",
    "number": "1619074291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4690 WOODSTOCK RD",
            "address_2": "SUITE 100",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300751678",
            "telephone_number": "770-992-6568",
            "fax_number": "770-992-9520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4690 WOODSTOCK RD",
            "address_2": "SUITE 100",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300751678",
            "telephone_number": "770-992-6568",
            "fax_number": "770-992-9520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL W. SHENK D.D.S. P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-17",
        "last_updated": "2013-03-26",
        "status": "A",
        "authorized_official_last_name": "SHENK",
        "authorized_official_first_name": "JUDD",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-992-6568",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D.."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN014141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shenk Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roswell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.