Charles G Shea DMD PC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DS-018700-L Issued in PA

Legal business name

CHARLES G SHEA DMD PC

Practice address

225 Vine St
Johnstown, PA 15901

Phone

(814) 535-7888

Fax

(814) 539-8858

NPI assigned

Feb 13, 2007

Last updated

Sep 19, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Charles G Shea, DMDNPI 1548697170

Title

Owner

Phone

(814) 535-7888

Specialties & licenses 1

Addresses

Other identifiers 2

Tax ID family

Charles G Shea DMD PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Charles G.Shea,DMD,PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Johnstown, PA
  • NPI 1356782700
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Charles Gordon Shea, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Johnstown, PA
  • NPI 1548697170
  Authorized official Same address or phone

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379548800000",
    "number": "1912049115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 VINE ST",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "15901",
            "telephone_number": "814-535-7888",
            "fax_number": "814-539-8858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 VINE ST",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "15901",
            "telephone_number": "814-535-7888",
            "fax_number": "814-539-8858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES G SHEA DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2013-09-19",
        "status": "A",
        "authorized_official_last_name": "SHEA",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "814-535-7888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "DS-018700-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015391880001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS",
            "identifier": "160535",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gi Ming Chan, ND
• John O. Chan, MD
• Bethany Chappell
• Chariot Johnstown Alf Operations Opco LLC (Amber Springs at Laurel Wood Care Center)
• Chariot Johnstown SNF Opco LLC (Laurel Wood Nursing & Rehabilitation Center)
• Charles G.Shea,DMD,PC
• Charles W. Stotler, M.D.
• Christine Mary Charney, M.A.
• Brandon Cheskiewicz, PHARMD
• Karly Chesla, CRNP

• Oral and Maxillofacial Surgery (Dentist) in Johnstown, PA
• Providers in Johnstown, PA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2013; 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.