NPIMap

Organization Active NPI

North Jackson Dental Care

Doing business as Stephen Scott Shepherd DMD

  • Dentist
  • Stevenson, AL
National Provider Identifier
1659456879
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
3796 Issued in AL
Legal business name
NORTH JACKSON DENTAL CARE
Doing business as
Stephen Scott Shepherd DMD
Practice address
105 Adams Street
Stevenson, AL 35772
Phone
(256) 437-2191
Fax
(256) 437-1066
NPI assigned
Oct 26, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Stephen Scott Shepherd, DMDNPI 1770643371
Title
Dr President of Corporation
Phone
(256) 437-2191

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
Dentist 122300000X 3796 AL Primary

Addresses

Primary practice location

105 Adams Street
Stevenson, AL 35772

Mailing address

105 Adams Street
Stevenson, AL 35772
Phone (256) 437-2191

Other identifiers 2

IdentifierTypeStateIssuer
595965OtherUNITED CONCORDIA
3093026OtherTNBLUE CROSS BLUE SHIELD

Other names 1

  • Stephen Scott Shepherd DMD Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1659456879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 ADAMS STREET",
            "city": "STEVENSON",
            "state": "AL",
            "postal_code": "35772",
            "telephone_number": "256-437-2191",
            "fax_number": "256-437-1066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 ADAMS STREET",
            "city": "STEVENSON",
            "state": "AL",
            "postal_code": "35772",
            "telephone_number": "256-437-2191",
            "fax_number": "256-437-1066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH JACKSON DENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHEPHERD",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "DR PRESIDENT OF CORPORATION",
        "authorized_official_telephone_number": "256-437-2191",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AL",
            "license": "3796",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "595965",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "3093026",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stephen Scott Shepherd DMD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stevenson, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.