NPIMap

Organization Active NPI

Shepherd Lane Dental

  • Dentist
  • Dallas, TX
National Provider Identifier
1619276532
Registry record updated Mar 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22654 Issued in TX
Legal business name
SHEPHERD LANE DENTAL
Practice address
312 S Beckley Ave
Dallas, TX 75203-2614
Phone
(214) 941-4455
Fax
(214) 941-4464
NPI assigned
Mar 17, 2011
Last updated
Mar 17, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2011

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

Authorized official

Name
Mr. Holland Morrison, DDS
Title
President
Phone
(972) 416-5755

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 22654 TX Primary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 22654 TX

Addresses

Primary practice location

312 S Beckley Ave
Dallas, TX 75203-2614

Mailing address

1103 S Josey LN
Ste 707
Carrollton, TX 75006-7680
Phone (972) 416-5755

National Provider Directory

National Provider Directory
Tax ID family
All American Mobile Dentistry Unit8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1300320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300320000000",
    "number": "1619276532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 S JOSEY LN",
            "address_2": "STE 707",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750067680",
            "telephone_number": "972-416-5755",
            "fax_number": "972-820-6089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 S BECKLEY AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752032614",
            "telephone_number": "214-941-4455",
            "fax_number": "214-941-4464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHEPHERD LANE DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-17",
        "last_updated": "2011-03-17",
        "status": "A",
        "authorized_official_last_name": "MORRISON",
        "authorized_official_first_name": "HOLLAND",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-416-5755",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "22654",
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TX",
            "license": "22654",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2011; 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.