Shamrock Dental Group, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2002031756 Issued in MO

Legal business name

SHAMROCK DENTAL GROUP, LLC

Practice address

2502 William St
Suite 2a
Cape Girardeau, MO 63703-5763

Phone

(573) 334-6009

Fax

(573) 334-7675

NPI assigned

Apr 17, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Robert Haberkorn, D.D.S , M.B.A

Title

Dentist

Phone

(573) 334-6009

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1208390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208390400000",
    "number": "1831363027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2502 WILLIAM ST",
            "address_2": "SUITE 2A",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637035763",
            "telephone_number": "573-334-6009",
            "fax_number": "573-334-7675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2502 WILLIAM ST",
            "address_2": "SUITE 2A",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637035763",
            "telephone_number": "573-334-6009",
            "fax_number": "573-334-7675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAMROCK DENTAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-17",
        "last_updated": "2008-04-17",
        "status": "A",
        "authorized_official_last_name": "HABERKORN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "573-334-6009",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S , M.B.A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2002031756",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1005255/106930",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nathan Thomas Seyer, D.D.S.
• Christi Ann Shafer, RD, LD
• Krista Shaffer
• Shalimar Corp
• Shalimar Corp. D/B/a Parkwood Manor
• James Daniel Shandy, BC-HIS
• Katheryne Jenna Sharp, BCBA
• Teena L Sharrock, MD
• Zachary Shaw, AU.D.
• John Sheets, DDS

• General Practice Dentistry in Cape Girardeau, MO
• Providers in Cape Girardeau, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2008; 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.