Shad J. Lewis, DMD Ma LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SHAD J. LEWIS, DMD MA LLC

Doing business as

Shad J. Lewis DMD

Practice address

2211 Quarry Dr
Reading, PA 19609-1161

Phone

(610) 678-5700

NPI assigned

Jun 23, 2020

Last updated

Jun 23, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Shad John Lewis, DMDNPI 1093809147

Title

Owner/Dentist

Phone

(610) 678-5700

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Shad J. Lewis DMD Doing business as

Locations

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.

• Shad John Lewis, DMD

  • Dentist
  • Reading, PA
  • NPI 1093809147
  NPD Authorized official

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

{
    "created_epoch": "1592870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592870400000",
    "number": "1699391896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 QUARRY DR",
            "city": "READING",
            "state": "PA",
            "postal_code": "196091161",
            "telephone_number": "610-678-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 QUARRY DR",
            "city": "READING",
            "state": "PA",
            "postal_code": "196091161",
            "telephone_number": "610-678-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAD J. LEWIS, DMD MA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-23",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "SHAD",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "610-678-5700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019646560003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shad J. Lewis DMD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Service Access and Management Inc
• Service Access and Management Inc
• Manifay Hajallie Sesay
• SG1 Dental LLC
• Safwan Ibrahim Shaaya, D.D.S.
• Rosemary S Shade, LCSW
• Abigail Shafer
• Eugene Michael Shaffer, MD
• Kshitil Shah, PHARMD
• Waqar Haider Shah, PHARM.D.

• Dental Clinic/Center in Reading, PA
• Providers in Reading, PA by specialty
• Dental Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 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.