Parker Shiffler, DDS, MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

11640344-9924 Issued in UT

Practice address

7390 S Creek Rd Ste 101
Sandy, UT 84093-6121

Phone

(801) 255-2422

NPI assigned

May 1, 2013

Last updated

Apr 13, 2022By 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 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 9, 2023 through Feb 9, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Creekside Oral & Facial Surgery Inc

  • Oral and Maxillofacial Surgery (Dentist)
  • Sandy, UT
  • NPI 1679943831
  NPD (past)
• Ut Oms Specialty Dental Services PLLC

  dba Aspire Surgical

  • Oral and Maxillofacial Surgery (Dentist)
  • Heber City, UT
  • NPI 1831956770
  NPD (past)

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

{
    "created_epoch": "1367366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649808000000",
    "number": "1639514896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7390 S CREEK RD STE 101",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840936121",
            "telephone_number": "503-756-5726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7390 S CREEK RD STE 101",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840936121",
            "telephone_number": "801-255-2422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIFFLER",
        "first_name": "PARKER",
        "credential": "DDS, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-01",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "64079",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "UT",
            "license": "11640344-9924",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Shelton, DPM
• Amanda Shepard
• Kevin Craig Sherman, L.C.S.W.
• Marissa Elizabeth Sherman, M.S., CMHC, PCI
• Stephanie Shew, DPT
• George A Shirley
• Shopko Stores Operating Co LLC (ShopKo Pharmacy 083)
• Shopko Stores Operating Co. LLC (ShopKo Optical 083)
• Gabriela Silva, CHES
• Joshua Taylor Silva, M.D.

• Oral and Maxillofacial Surgery (Dentist) in Sandy, UT
• Providers in Sandy, UT by specialty
• Oral and Maxillofacial Surgery (Dentist) in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2022; 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.