Nicolas J. Shane, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5000948-015 Issued in WI

Practice address

N79W14756 Appleton Ave
Suite 100
Menomonee Falls, WI 53051-4376

Phone

(262) 251-2010

Fax

(262) 251-5690

NPI assigned

Jul 27, 2006

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Village Dental Group, S.C.

  • General Practice Dentistry
  • Menomonee Falls, WI
  • NPI 1952362287
  NPD (past)

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922012038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N79W14756 APPLETON AVE",
            "address_2": "SUITE 100",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530514376",
            "telephone_number": "262-251-2010",
            "fax_number": "262-251-5690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N79W14756 APPLETON AVE",
            "address_2": "SUITE 100",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530514376",
            "telephone_number": "262-251-2010",
            "fax_number": "262-251-5690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANE",
        "first_name": "NICOLAS",
        "middle_name": "J.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5000948-015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark W Semrad, DO
• Andres Sercovich, PHARMD
• Annika Shaffer
• Manan Shirishkumar Shah, MD
• Joseph L Shaker, MD
• Bhavin Shastri, MD
• Jennifer K Shaw, RD CD
• Laurie Joan Shawger, LPC
• Shema and Buda Logistics LLC
• Dennis W Shepherd, M.D.

• General Practice Dentistry in Menomonee Falls, WI
• Providers in Menomonee Falls, WI by specialty
• General Practice Dentistry in Wisconsin

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.