Caroline Shepherd, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019027016 Issued in IL

Practice address

1394 S Route 12
Fox Lake, IL 60020-1949

Phone

(847) 587-5053

NPI assigned

Jan 25, 2007

Last updated

Jun 18, 2008By the provider in NPPES

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Daniel a Dohnalek DDS LTD

  dba Manus Dental Fox Lake

  • General Practice Dentistry
  • Fox Lake, IL
  • NPI 1225144637
  NPD (past)
• Thomas L. Prendergast, DDS, PC

  • General Practice Dentistry
  • Fox Lake, IL
  • NPI 1639438765
  NPD (past)

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213747200000",
    "number": "1972658094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3078 NICKLAUS LN",
            "city": "WADSWORTH",
            "state": "IL",
            "postal_code": "600838944",
            "telephone_number": "847-672-9569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1394 S ROUTE 12",
            "city": "FOX LAKE",
            "state": "IL",
            "postal_code": "600201949",
            "telephone_number": "847-587-5053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPHERD",
        "first_name": "CAROLINE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2008-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019027016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martina Schmidt, LMT
• Michl Schmidt
• Crystal C Scholten, DPT
• Kirsten Nicole Schreiner, DPT
• Sharilee Shaver, CADC
• Shoptikal LLC (Shopko Optical 4258)
• Amber Nicole Shrum, LSW, CADC
• Navneet Singh, PHARM.D
• Kathleen A Skoli, D.N.
• Kellen M Smith

• General Practice Dentistry in Fox Lake, IL
• Providers in Fox Lake, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; 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.