Amanda Shaffer, DMD

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

019032027 Issued in IL

Practice address

1448 W Madison St Ste 1
Chicago, IL 60607-1822

Phone

(773) 972-4535

NPI assigned

Apr 23, 2018

Sex

Female

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 IL

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": "1524441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1962999276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1448 W MADISON ST STE 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606071822",
            "telephone_number": "773-972-4535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1448 W MADISON ST STE 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606071822",
            "telephone_number": "773-972-4535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFFER",
        "first_name": "AMANDA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-23",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IL",
            "license": "019032027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adam Lloyd Shafer, PSY.D.
• Jonathan Meyer Shafer, DNP, APRN, PMHNP-BC
• Katherine Shafer, LCPC
• Natalie Ann Shafer, LPC
• Shaffer Counseling Solutions P.C.
• Jordan Lorraine Shaffer
• Lemuel Joseph Shaffer, M.D.
• Lorraine E Shaffer, R.PH.
• Matthew Truman Shaffer, LCSW
• Seth Shaffer, MD

• Pediatric Dentistry in Chicago, IL
• Providers in Chicago, IL by specialty
• Pediatric Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; 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.