DR. MICHAEL DERAE SHEPPARD (NPI# 1871547893) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871547893 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL DERAE SHEPPARD |
| Credential | DDS |
| Practice Address |
2310 Fm 157 North Suite 103 Mansfield TX 76063 |
| Practice Telephone | 8174770922 |
| Practice Fax Number | 8174770910 |
| Mailing Telephone | 8174770922 |
| Mailing Fax Number | 8174770910 |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2009-03-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
21182 | TX | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689057051 | Michael Sheppard | Contractor | 23w632 Maple Ave, Roselle, IL 60172-2131 | 2015-07-03 |
| 1487761763 | Michael Scott Sheppard | Chiropractor | 5912 Spencer Highway, Pasadena, TX 77505 | 2006-08-24 |
| 1447786728 | Michael Thomas Sheppard | Student in an Organized Health Care Education/Training Program | 515 Ray C Hunt Dr, Charlottesville, VA 22903 | 2017-05-05 |
| 1841640554 | Michael Sheppard | Counselor | 1 S Prospect St, Burlington, VT 05401-3456 | 2016-06-14 |
| 1417343708 | Michael Allen Sheppard | Pharmacist | 701 N 1st St, Springfield, IL 62781-0001 | 2015-04-13 |
| Street Address |
2310 FM 157 NORTH SUITE 103 |
| City | MANSFIELD |
| State | TX |
| Zip Code | 76063 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316558349 | Lindsey Vandyke, D.o. Pllc | Internal Medicine | 3150 E Broad Street, Ste 100, Mansfield, TX 76063 | 2020-08-13 |
| 1942819867 | Jennifer Que Chau Nguyen | Pharmacist | 980 U.S. 287 Frontage Rd #287, Mansfield, TX 76063 | 2020-07-27 |
| 1194346890 | Ana Maria Gonzalez | Dentist | 1600 Us Highway 287, Suite 102, Mansfield, TX 76063 | 2020-05-04 |
| 1245869080 | Stateserv Medical of Texas, LLC | Durable Medical Equipment & Medical Supplies | 7941 Rodeo Trail, Mansfield, TX 76063 | 2020-04-03 |
| 1649802232 | Mary Puanani Kamai | Nurse Practitioner | 1301 E. Debbie Lane, Suite 102 #1405, Mansfield, TX 76063 | 2020-02-11 |
| 1770123028 | Gladys Vera Nfodzo | Nurse Practitioner | 901 W. Broad St, Mansfield, TX 76063 | 2020-01-14 |
| 1669011300 | Alexa Smith | Nurse Practitioner | 2800 E Broad St #304, Mansfield, TX 76063 | 2019-12-28 |
| 1477190437 | Mel Rockwall LLC | Optometrist | 1701 East Broad Street, Ste 109, Mansfield, TX 76063 | 2019-12-09 |
| 1376185512 | Daniel Max & Marcandrea LLC | Optometrist | 1701 East Broad St., Ste 109, Mansfield, TX 76063 | 2019-10-09 |
| 1861046385 | Lacey Eaton | Counselor | 805 Killian Dr, Mansfield, TX 76063 | 2019-08-01 |
| Find all providers in zip 76063 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972771053 | Mansfield Oral and Facial Surgery | Dentist | 1705 Fountainview Dr #103, Mansfield, TX 76063 | 2008-02-12 |
| 1083793210 | Marie Christine Boucher | Dentist | 10 Higgins Highway, Mansfield, CT 06250 | 2006-11-06 |
| 1780632307 | Douglas Philip Sinn | Dentist | 1752 Broad Park Cir N, #100, Mansfield, TX 76063-7821 | 2006-05-05 |
| 1790752350 | Kenneth J. Molnar | Dentist | 2191 Park Ave W, Mansfield, OH 44906-1226 | 2006-03-02 |
| 1760003891 | Dynamic Dental Specialists, LLC | Dentist | 630 Lexington Ave, Mansfield, OH 44907-1500 | 2020-04-29 |
| 1306340567 | Oakwood Oral and Maxillofacial Surgery, Christopher N. Beale, Dds, LLC | Dentist | 630 Lexington Ave, Mansfield, OH 44907-1500 | 2018-03-22 |
| 1306077656 | Timothy Scott Bartholomew | Dentist | 630 Lexington Ave, Mansfield, OH 44907-1500 | 2009-08-05 |
| 1467694208 | The Center for Oral, Facial, and Implant Surgery Pa | Dentist | 2310 Highway 157 N, Suite 103, Mansfield, TX 76063-8844 | 2009-03-25 |
| 1518125749 | Dr Jon D Turesky Dmd | Dentist | 100 Copeland Drive, Mansfield, MA 02048 | 2008-05-23 |
| 1437357894 | Douglas P. Sinn, Dds, Pa | Dentist | 1752 Broad Park Cir N, #100, Mansfield, TX 76063-7821 | 2007-07-06 |
| Find all providers in MANSFIELD | ||||
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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.