ROBERT W SHAFER DDS LTD (NPI# 1184728768) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184728768 |
| Entity Type | Organization |
| Organization Name | ROBERT W SHAFER DDS LTD |
| Practice Address |
2902 Crossing Ct Suite A Champaign IL 61822-6175 |
| Practice Telephone | 2173569595 |
| Practice Fax Number | 2173566425 |
| Mailing Telephone | 2173569595 |
| Mailing Fax Number | 2173566425 |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2008-06-18 |
| Authorized Official Name | ROBERT WILLIAM SHAFER (ORTHODONTIST/OWNER) |
| Authorized Official Telephone | 2173569595 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
19022993 | IL | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | LICENSE | 19022993 | 01 |
| Street Address |
2902 CROSSING CT SUITE A |
| City | CHAMPAIGN |
| State | IL |
| Zip Code | 61822-6175 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508960170 | Robert William Shafer | Dentist | 2902 Crossing Ct, Suite A, Champaign, IL 61822-6175 | 2006-09-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083180830 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 2718 N Prospect Avenue, Champaign, IL 61822 | 2018-10-19 |
| 1487129730 | Siegfred T. Celis | Occupational Therapy Assistant | 1820 Oak Park Drive, Champaign, IL 61822 | 2018-10-12 |
| 1134633746 | Osf Healthcare System | Home Health | 1501 Interstate Dr Ste C, Champaign, IL 61822 | 2017-11-20 |
| 1386164200 | Carlo Sandico | Physical Therapist | 612 Corey Lane, Champagne, IL 61822 | 2017-06-21 |
| 1295270288 | Jennifer Lee Lugo | Registered Nurse | 3101 Fields South Dr., Champaign, IL 61822 | 2016-12-29 |
| 1902341209 | Jala Simmons | Behavioral Analyst | 4112 Fieldstone Rd, Suite B, Champaign, IL 61822 | 2016-12-22 |
| 1639552433 | Muhammad Ajmal | Internal Medicine | 1701 Curtis Road, Carle Clinic, Champaign, IL 61822 | 2015-06-30 |
| 1518363761 | Margaret A. Hallden | Hearing Instrument Specialist | 3354 Big Pine Trail #c, Audibel Hearing Aids, Champaign, IL 61822 | 2014-11-17 |
| 1801291638 | Kristen Karlsen | Pharmacist | 3114 Village Office Place, Champaign, IL 61822 | 2014-10-22 |
| 1649601543 | Jeff Chu | Optometrist | 507 W. Town Center Blvd, Champaign, IL 61822 | 2013-12-03 |
| Find all providers in zip 61822 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346739372 | Dana E. Fender, D.m.d., P.C. | Dentist | 1715 Broadmoor Dr Ste A, Champaign, IL 61821-5984 | 2018-05-04 |
| 1033266291 | Christopher N. Jordan | Dentist | 2920 Crossing Ct, Champaign, IL 61822-6163 | 2007-01-03 |
| 1508960170 | Robert William Shafer | Dentist | 2902 Crossing Ct, Suite A, Champaign, IL 61822-6175 | 2006-09-12 |
| 1710090444 | William John Mccabe Jr. | Dentist | 1715 Broadmoor Dr, Suite A, Champaign, IL 61821-5983 | 2006-08-16 |
| 1689686735 | Mark Huls | Dentist | 481 Devonshire Dr, Champaign, IL 61820-7230 | 2006-08-13 |
| 1730372012 | Heartland Family Dental Care of Illinois, PC | Dentist | 314 W Kirby Ave, Champaign, IL 61820-7208 | 2007-08-21 |
| 1376663799 | Gene Paul King | Dentist | 701 Devonshire Dr, Champaign, IL 61820-7337 | 2007-03-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427670421 | Braces By Barnes | Dentist | 1335 E 87th St Ste B, Chicago, IL 60619-7036 | 2020-05-12 |
| 1790310431 | Gregory D Long II | Dentist | 7131 N Knoxville Ave Ste B, Peoria, IL 61614-2088 | 2020-03-03 |
| 1073147682 | Collinsville Orthodontics Pllc | Dentist | 93 Crestmoor St, Collinsville, IL 62234-4952 | 2020-02-24 |
| 1740812494 | Bankhead Alton Orthodontics PC | Dentist | 2828 Homer Adams Pkwy, Alton, IL 62002-4855 | 2020-02-11 |
| 1336779164 | Orthodontic Experts, Ltd | Dentist | 2987 Kirk Rd Ste 103a, Aurora, IL 60502-6014 | 2020-01-21 |
| 1922645308 | Riddhi J Desai Dmd Pllc | Dentist | 727 W Madison St Apt 1208, Chicago, IL 60661-2409 | 2019-12-04 |
| 1295379691 | Orthodontic Experts, Ltd | Dentist | 1351 N Larkin Ave, Joliet, IL 60435-3753 | 2019-10-30 |
| 1407409071 | Barysenka LLC | Dentist | 124 N California St, Sycamore, IL 60178-1402 | 2019-07-22 |
| 1346806577 | Pulaski Smiling Dental P.C. | Dentist | 5540 S Pulaski Rd Fl 1, Chicago, IL 60629-4418 | 2019-05-13 |
| 1750944252 | Candid Illinois, Pllc | Dentist | 750 N Franklin St Fl Stc2, Chicago, IL 60654-6263 | 2019-04-19 |
| Find all providers with the same taxonomy | ||||
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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.