NPIMap

Organization Active NPI

Sheppard Periodontics, SC

  • Periodontics
  • Hoffman Estates, IL
National Provider Identifier
1851566400
Registry record updated Apr 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
019026359 Issued in IL
Legal business name
SHEPPARD PERIODONTICS, SC
Practice address
990 Grand Canyon Pkwy
Suite 320
Hoffman Estates, IL 60169-1739
Phone
(847) 885-1664
Fax
(847) 885-1705
NPI assigned
Apr 24, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2008

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

Authorized official

Name
Dr. Kimberly Dawn Sheppard, DDSNPI 1811983463
Title
President/Periodontist
Phone
(847) 885-1664

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X 019026359 IL Primary

Addresses

Primary practice location

990 Grand Canyon Pkwy
Suite 320
Hoffman Estates, IL 60169-1739

Mailing address

990 Grand Canyon Pkwy
Suite 320
Hoffman Estates, IL 60169-1739
Phone (847) 885-1664

National Provider Directory

National Provider Directory

Locations

990 Grand Canyon Pkwy
Ste 320
Hoffman Estates, IL 60169
Phone (847) 885-1664

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1208995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208995200000",
    "number": "1851566400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 GRAND CANYON PKWY",
            "address_2": "SUITE 320",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601691739",
            "telephone_number": "847-885-1664",
            "fax_number": "847-885-1705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 GRAND CANYON PKWY",
            "address_2": "SUITE 320",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601691739",
            "telephone_number": "847-885-1664",
            "fax_number": "847-885-1705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHEPPARD PERIODONTICS, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-24",
        "last_updated": "2008-04-24",
        "status": "A",
        "authorized_official_last_name": "SHEPPARD",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "PRESIDENT/PERIODONTIST",
        "authorized_official_telephone_number": "847-885-1664",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "IL",
            "license": "019026359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hoffman Estates, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.