Daniel Shane Edwards, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

18117 Issued in TX

Practice address

103 N Brentwood Ste 400
Lufkin, TX 75904-7147

Phone

(366) 394-8679

Fax

(936) 639-4868

NPI assigned

May 29, 2007

Last updated

Sep 15, 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Dr. D. Shane Edwards

  • Dentist
  • Frisco, TX
  • NPI 1649440801
  NPD (past) Authorized official

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1770784746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 HARLAN RD",
            "city": "POTTSBORO",
            "state": "TX",
            "postal_code": "750764101",
            "telephone_number": "214-632-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 N BRENTWOOD STE 400",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759047147",
            "telephone_number": "366-394-8679",
            "fax_number": "936-639-4868"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24179 State Highway 249 Ste B",
            "address_purpose": "LOCATION",
            "city": "Tomball",
            "state": "TX",
            "postal_code": "773758299",
            "country_code": "US",
            "telephone_number": "281-357-9460",
            "fax_number": "281-357-9464",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8200 Stonebrook Pkwy Ste 208",
            "address_purpose": "LOCATION",
            "city": "Frisco",
            "state": "TX",
            "postal_code": "750345588",
            "country_code": "US",
            "telephone_number": "972-335-3131",
            "fax_number": "469-633-1297",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "DANIEL",
        "middle_name": "SHANE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-29",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "18117",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "18117",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "752851171",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Educare Community Living Limited Partnership
• Educare Community Living Limited Partnership
• Educare Community Living Limited Partnership
• Educare Community Living Limited Partnership
• Educare Community Living Limited Partnership
• Leanne Marie Ehlers-Anderson, R.D., L.D
• Element Dental PLLC (Element Dental & Orthodontics)
• Elite Hospice and Palliative Care, LLC
• Elite Medical Home Care LP
• Tara Jo Elizondo, PMHNP

• Dentist in Lufkin, TX
• Providers in Lufkin, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2022; 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.