NPIMap

Organization Active NPI

Shepherd Lane Dental Associates,PC

  • General Practice Dentistry
  • Carrollton, TX
National Provider Identifier
1962526020
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7005 Issued in TX
Legal business name
SHEPHERD LANE DENTAL ASSOCIATES,PC
Practice address
1103 S Josey LN Ste 707
Carrollton, TX 75006-7389
Phone
(972) 416-5755
Fax
(972) 416-9812
NPI assigned
Mar 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Sammie Walker
Title
Manager
Phone
(972) 416-5755

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 7005 TX Primary

Addresses

Primary practice location

1103 S Josey LN Ste 707
Carrollton, TX 75006-7389

Mailing address

1103 S Josey LN Ste 707
Carrollton, TX 75006-7389
Phone (972) 416-5755

National Provider Directory

National Provider Directory
Tax ID family
Shepherd Lane Dental Associates8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

1103 S Josey Ln
Ste 707
Carrollton, TX 75006
Phone (972) 416-5755

NPI Registry JSON

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1962526020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 S JOSEY LN STE 707",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750067389",
            "telephone_number": "972-416-5755",
            "fax_number": "972-416-9812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 S JOSEY LN STE 707",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750067389",
            "telephone_number": "972-416-5755",
            "fax_number": "972-416-9812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHEPHERD LANE DENTAL ASSOCIATES,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "SAMMIE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "972-416-5755"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "7005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.