Dennis D Shepard MD Inc

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

050000322 Issued in CA

Legal business name

DENNIS D SHEPARD MD INC

Doing business as

Shepard Eye Center Medical Group

Practice address

1418 E Main St
Ste 110
Santa Maria, CA 93454

Phone

(805) 614-7005

Fax

(805) 614-7006

NPI assigned

May 2, 2006

Organization subpart

No

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

Authorized official

Name

Dennis Shepard, MD

Title

President

Phone

(805) 614-7005

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Shepard Eye Center Medical Group Doing business as

Locations

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208995200000",
    "number": "1982662771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1418 E MAIN ST",
            "address_2": "STE 110",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "93454",
            "telephone_number": "805-614-7005",
            "fax_number": "805-614-7006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1418 E MAIN ST",
            "address_2": "STE 110",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "93454",
            "telephone_number": "805-614-7005",
            "fax_number": "805-614-7006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENNIS D SHEPARD MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-02",
        "last_updated": "2008-04-24",
        "status": "A",
        "authorized_official_last_name": "SHEPARD",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-614-7005",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "050000322",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CA",
            "identifier": "ZZZH4200Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SUR01010F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shepard Eye Center Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brooke Allison Delkeskamp, APRN
• Judy April Delong
• Ispa Delongpre
• Ashley Marie Delrio
• Dennis D Shepard MD Inc
• Debora Rhen Dennis, M.A.
• Sam Densen, MD
• Dental Surgery Centers of America
• Paraon Nolasc Dequiroz, DDS
• Derek NG DDS Inc

• Ambulatory Surgical Clinic/Center in Santa Maria, CA
• Providers in Santa Maria, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.