Clifford R Shedd, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Practice address

Unit 26610
Bavaria Dental Activity Credentials Office
Apo Ae, NY 09244

Phone

(931) 804-3933

Fax

(931) 804-2524

NPI assigned

Apr 26, 2006

Last updated

Jul 8, 2007By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902862030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UNIT 26610",
            "address_2": "BAVARIA DENTAL ACTIVITY CREDENTIALS OFFICE",
            "city": "APO AE",
            "state": "NY",
            "postal_code": "09244",
            "telephone_number": "931-804-3933",
            "fax_number": "931-804-2524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UNIT 26610",
            "address_2": "BAVARIA DENTAL ACTIVITY CREDENTIALS OFFICE",
            "city": "APO AE",
            "state": "NY",
            "postal_code": "09244",
            "telephone_number": "931-804-3933",
            "fax_number": "931-804-2524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEDD",
        "first_name": "CLIFFORD",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James C Rising, D.M.D.
• Aligna I Rodriguez, D.M.D.
• Kerri Ann Rogers, RDH
• Mary S Ross, LCSW
• Joan Rubino, DDS
• Mona E. Skaff, DMD
• George Smolinski, M.D.
• Thomas Keith Spears, DMD
• Amy Marie Stacey, RN
• Chester John Summers, DDS

• General Practice Dentistry in Apo Ae, NY
• Providers in Apo Ae, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.