Cameron Stone Shepherd

Primary specialty

DentistTaxonomy code 122300000X

License

DEN.00205677 Issued in CO

Practice address

4972 E 62ND Ave Unit B1
Commerce City, CO 80022-3253

Phone

(303) 288-4969

NPI assigned

May 8, 2023

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1683504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1790475465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4972 E 62ND AVE UNIT B1",
            "city": "COMMERCE CITY",
            "state": "CO",
            "postal_code": "800223253",
            "telephone_number": "303-288-4969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4972 E 62ND AVE UNIT B1",
            "city": "COMMERCE CITY",
            "state": "CO",
            "postal_code": "800223253",
            "telephone_number": "303-288-4969"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1919 7th Ave S",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352332005",
            "country_code": "US",
            "telephone_number": "205-934-3387",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEPHERD",
        "first_name": "CAMERON",
        "middle_name": "STONE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-08",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN28070",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "DEN.00205677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Serenity Home Health Service LLC
• Set Apart Treatment, Inc.
• Cindy Shand, RN
• Tripti Sharma, MA
• Leilana Rose Shattuck
• Shiloh Home Inc.
• Shiloh Home Inc.
• Esther Soojin Shin, MD
• Molly Short
• Emma Sickles, RDN, CLC

• Dentist in Commerce City, CO
• Providers in Commerce City, CO by specialty
• Dentist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2023; 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.