DR. JAMES M. SHADDOCK III (NPI# 1568584142) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568584142 |
| Entity Type | Individual |
| Full Name | DR. JAMES M. SHADDOCK III |
| Credential | DDS |
| Practice Address |
516 N. Brisbane Ave Greeley CO 80634 |
| Mailing Address |
516 N. Brisbane Ave. Greeley CO 80634 |
| Practice Telephone | 9703562605 |
| Mailing Telephone | 9703027508 |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2014-04-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
430 | CO | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 02043016 | 05 |
| Street Address |
516 N. BRISBANE AVE |
| City | GREELEY |
| State | CO |
| Zip Code | 80634 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831707843 | Witting Medical, LLC | Pathology | 17 Dos Rios, Greeley, CO 80634 | 2020-07-15 |
| 1730706102 | Heart Centered Counseling | Counselor | 1770 W 25th Street #206, Greeley, CO 80634 | 2020-07-01 |
| 1396374237 | Kidstuff Child and Family Counseling, P.C. | Counselor | 1770 25th Ave., Ste. 102, Greeley, CO 80634 | 2020-04-03 |
| 1164055745 | Stephanie Alexis Balunda | Speech-Language Pathologist | Uchealth Physical Therapy and Rehabilitation Clinic, 6767 West 29th St., Greeley, CO 80634 | 2020-02-21 |
| 1407413727 | Stephen P Street Pllc | Counselor | 4657 W. 20th Street, Unit B, Greeley, CO 80634 | 2019-05-22 |
| 1043797749 | Burt Stewart Dmd Pllc | Clinic/Center | 6937 West 10th Street, Greeley, CO 80634 | 2018-07-25 |
| 1164913885 | Innovations Pediatric Therapy, LLC | Occupational Therapist | 3403 W 7th St Apt A, Greeley, CO 80634 | 2018-05-29 |
| 1003305319 | Austin Michael Lake | Physical Therapist | 4681 W 20th St Unit 202b, Greeley, CO 80634 | 2018-05-02 |
| 1225542004 | Kevin Lichner | Specialist/Technologist | 522 28th Ave, Greeley, CO 80634 | 2017-11-30 |
| 1538683909 | Stacie Jackson | Physician Assistant | 6500 West 29th St Ste 106, Greeley, CO 80634 | 2017-07-27 |
| Find all providers in zip 80634 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992321400 | Taha Syed Aziz | Dentist | 3400 W 16th St # 8e, Greeley, CO 80634-6862 | 2020-06-20 |
| 1568972883 | G Dental LLC | Dentist | 2918 W 10th St Ste 5, Greeley, CO 80634-5457 | 2017-10-02 |
| 1801324298 | Shawn Michael Custer | Dentist | 3400 W 16th St Ste 8e, Greeley, CO 80634-6862 | 2017-05-30 |
| 1679017560 | Dentists of Greeley, LLP | Dentist | 4421 Centerplace Dr, Suite A, Greeley, CO 80634-3756 | 2016-12-12 |
| 1316311012 | Cornerstone Orthodontics, LLC | Dentist | 1825 56th Avenue Unit A, Greeley, CO 80634 | 2015-11-18 |
| 1023421435 | Matthew Lee | Dentist | 2525 W 16th St Ste A, Greeley, CO 80634-4951 | 2014-06-04 |
| 1750678439 | Greeley Modern Dentistry, LLP | Dentist | 6632 10th Street Suite 101, Greeley, CO 80634 | 2011-07-01 |
| 1013132737 | Gregory Lyle Obermann | Dentist | 7251 West 20th Street, Bldg.h-2, Greeley, CO 80634 | 2007-04-16 |
| 1780705939 | Steven Eugene Bagley | Dentist | 913 27th Ave, Greeley, CO 80634-5808 | 2007-04-03 |
| 1790806479 | Perfect Teeth - Greeley P.C. | Dentist | 902 14th St, Greeley, CO 80631-4622 | 2007-04-02 |
| Find all providers in GREELEY | ||||
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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.