SHANE DAVIDSON DDS PC (NPI# 1033651427) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033651427 |
| Entity Type | Organization |
| Organization Name | SHANE DAVIDSON DDS PC |
| Practice Address |
5574 Cooley Lake Rd Waterford MI 48327-3015 |
| Practice Telephone | 2489773006 |
| Mailing Telephone | 2489773006 |
| Enumeration Date | 2016-11-16 |
| Last Update Date | 2016-11-16 |
| Authorized Official Name | SHANE DAVIDSON (OWNER) |
| Authorized Official Telephone | 2489773006 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | Y |
| Parent Organization Name | SHANE DAVIDSON DDS PC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 2901020222 | MI | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 2901020222 | 05 |
| Street Address |
5574 COOLEY LAKE RD |
| City | WATERFORD |
| State | MI |
| Zip Code | 48327-3015 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144492067 | Wayne Eric Pickett | Dentist | 5574 Cooley Lake Rd, Waterford, MI 48327-3015 | 2008-04-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700418555 | Dental House - Waterford, Pllc | Clinic/Center | 5979 Highland Road, Waterford Twp, MI 48327 | 2020-02-10 |
| 1063924793 | Carolyn Mirretti | Social Worker | 7110 Round Hill Drive, Apt. A2, Waterford, MI 48327 | 2017-11-03 |
| 1972022358 | Mary Frances Halfpenny | Registered Nurse | 5741 Berkley Dr, Waterford, MI 48327 | 2017-09-17 |
| 1407377443 | Crystal Marie Degrandchamp | Counselor | 1370 N. Oakland Blvd., Suite 105, Waterford, MI 48327 | 2017-06-29 |
| 1366987489 | Graceful Living, Reinventing In-home Senior Care | Home Health | 6926 Highland Road, Suite 2, Waterford, MI 48327 | 2016-12-28 |
| 1134678378 | Jacqueline Bleisch | Home Health | 2440 Jones Rd., Waterford, MI 48327 | 2016-09-29 |
| 1033665385 | Charles Weems | Counselor | Meridian Health Services, 1255 N. Oakland Blvd., Waterford, MI 48327 | 2016-08-28 |
| 1124480777 | Raymond S Kanar | Counselor | 1255 North Oakland Blvd., Waterford, MI 48327 | 2016-03-23 |
| 1750765798 | Shatha Matti | Pharmacist | 7362 Highland Road, Waterford, MI 48327 | 2015-07-18 |
| 1548647233 | Oakland Physicians Medical Center LLC | Clinic/Center | 1035 N. Oakland Blvd., Waterford, MI 48327 | 2015-05-01 |
| Find all providers in zip 48327 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902421035 | Anthony Jacob Laszlo | Dentist | 3714 Sashabaw Rd, Waterford, MI 48329-2067 | 2020-06-15 |
| 1821401068 | Logan Conrad Smith | Dentist | 2340 Marwood Dr, Waterford, MI 48328-1633 | 2014-06-05 |
| 1386938561 | Amanda Marie Sheehan | Dentist | 4626 W Walton Blvd, Waterford, MI 48329-3535 | 2011-06-05 |
| 1417263120 | Metro Imaging Center Plc | Dentist | 4664 W. Walton Blvd., Waterford, MI 48329 | 2010-08-19 |
| 1336468941 | Dinesh Nandlal Patel | Dentist | 9271 Peach Street, Waterford, PA 16441 | 2010-05-21 |
| 1316139637 | Mary Ann Harchick | Dentist | 4204 Pontiac Lake Rd, Waterford, MI 48328 | 2007-08-10 |
| 1336359579 | David M Luciw | Dentist | 4914 Highland Rd, Waterford, MI 48328-1142 | 2007-05-23 |
| 1598979676 | Elaine Gantz, D.d.s., P.C. | Dentist | 4005 Highland Rd., Waterford, MI 48328-2134 | 2007-05-09 |
| 1568687531 | Brian E Lentz Dmd PC | Dentist | 850 Cherry Street, Waterford, PA 16441-0817 | 2007-04-16 |
| 1962556498 | Mark Andrew Laszlo | Dentist | 4624 Walton Blvd, Waterford, MI 48329 | 2007-01-22 |
| Find all providers in WATERFORD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.