William Dean Shattuck, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

31589 Issued in TX

Practice address

295 FM 156 S.
Suite 200
Haslet, TX 76052

Phone

(817) 439-8393

NPI assigned

Jun 25, 2012

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

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• William Shattuck, DDS, PLLC

  • General Practice Dentistry
  • Haslet, TX
  • NPI 1205293883
  NPD (past) Authorized official
• Luke Riley and Company PLLC

  • Dental Clinic/Center
  • Haslet, TX
  • NPI 1649849464
  NPD (past)

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

{
    "created_epoch": "1340582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459468800000",
    "number": "1831453869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14208 TIJUANA TRL",
            "city": "HASLET",
            "state": "TX",
            "postal_code": "760524894",
            "telephone_number": "214-934-9287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 FM 156 S.",
            "address_2": "SUITE 200",
            "city": "HASLET",
            "state": "TX",
            "postal_code": "76052",
            "telephone_number": "817-439-8393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHATTUCK",
        "first_name": "WILLIAM",
        "middle_name": "DEAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-25",
        "last_updated": "2016-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "6430",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "31589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zaira Y Salas Lira
• Matthew Sapit, CSFA
• Palma Mae Savala, RN
• Nicole Scott, M.S., SLP
• Paulette M See, MD
• Tammie Lee Shelton, LPC-S
• Randy Shipp, PHARMD
• Steven James Shook, AGACNP-BC
• Alicia Paige Short, DPT
• Ruasha Shrestha, DMD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.