Shepard Family Dentistry, P.C.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SHEPARD FAMILY DENTISTRY, P.C.

Practice address

3911 Coon Rapids Blvd NW
Coon Rapids, MN 55433-2520

Phone

(763) 421-0770

Fax

(763) 421-0772

NPI assigned

Mar 13, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Clayton Roland Shepard, DDSNPI 1700875077

Title

Dentist

Phone

(763) 421-0770

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Clayton Roland Shepard, D.D.S.

  • Dentist
  • Kalispell, MT
  • NPI 1700875077
  NPD (past) Authorized official

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

{
    "created_epoch": "1678665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678665600000",
    "number": "1982305454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3911 COON RAPIDS BLVD NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332520",
            "telephone_number": "763-421-0770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3911 COON RAPIDS BLVD NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332520",
            "telephone_number": "763-421-0770",
            "fax_number": "763-421-0772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHEPARD FAMILY DENTISTRY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-13",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A",
        "authorized_official_last_name": "SHEPARD",
        "authorized_official_first_name": "CLAYTON",
        "authorized_official_middle_name": "ROLAND",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "763-421-0770",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alia Sharif, M.D.
• Saada Oumer Shato
• Qiying She, NP
• McKenna Shearer, O.T.R
• Deborah Shefa, PA-C
• Sara Sheppard, OTR/L
• Sudi Shire
• Tiandra M Shrestha
• Judith Neh Shu Tse, APRN, CNP
• Sherron Sidney

• Dental Clinic/Center in Coon Rapids, MN
• Providers in Coon Rapids, MN by specialty
• Dental Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; 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.