JAMES A SHUPE DDS, DENTISTRY FOR CHILDREN, INC (NPI# 1124127832) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124127832 |
| Entity Type | Organization |
| Organization Name | JAMES A SHUPE DDS, DENTISTRY FOR CHILDREN, INC |
| Practice Address |
3030 Lake Ave Suite 15 Fort Wayne IN 46805-5428 |
| Practice Telephone | 2604228419 |
| Practice Fax Number | 2604223591 |
| Mailing Telephone | 2604228419 |
| Mailing Fax Number | 2604223591 |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | JAMES A SHUPE JR. (PRESIDENT) |
| Authorized Official Telephone | 2604228419 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
54000026A | IN | Dental Providers |
| Street Address |
3030 LAKE AVE SUITE 15 |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46805-5428 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073507745 | Thomas P Van Den Driessche | Family Medicine | 3030 Lake Ave, Suite32, Fort Wayne, IN 46805-5428 | 2005-09-08 |
| 1417494170 | Linzie Tuck | Behavioral Analyst | 3030 Lake Ave, Suite 20, Fort Wayne, IN 46805-5428 | 2017-01-19 |
| 1447587696 | Indiana Endocrine Specialist, LLC | Clinic/Center | 3030 Lake Ave, Suite 17, Fort Wayne, IN 46805-5428 | 2009-11-09 |
| 1225204613 | Marilyn Arlene Nathan | Psychologist | 3030 Lake Ave, Fort Wayne, IN 46805-5428 | 2008-05-05 |
| 1538349956 | Thomas P Van Den Driessche | Family Medicine | 3030 Lake Ave, Suite 32, Fort Wayne, IN 46805-5428 | 2007-11-14 |
| 1417156456 | Nora Marie Stewart | Audiologist-Hearing Aid Fitter | 3030 Lake Ave, Suite 23, Fort Wayne, IN 46805-5428 | 2007-07-11 |
| 1093916959 | Little Turtle Pediatrics, P.C. | Pediatrics | 3030 Lake Ave, Suite 10, Fort Wayne, IN 46805-5428 | 2007-05-29 |
| 1780899096 | Michael Joseph Luarde | Dentist | 3030 Lake Ave, Suite 19, Fort Wayne, IN 46805-5428 | 2007-05-11 |
| 1093938102 | Interdisciplinary Diagnostic and Evaluation Center, Inc. | Clinic/Center | 3030 Lake Ave, Suite 7, Fort Wayne, IN 46805-5428 | 2007-04-10 |
| 1790801512 | Pediatric & Adult Allergy Asthma & Immunology Specialists, LLC | Allergy & Immunology | 3030 Lake Ave, Suite 27, Fort Wayne, IN 46805-5428 | 2007-03-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619589546 | Connor Gemlick | Student in an Organized Health Care Education/Training Program | 1918 Carew St., Fort Wayne, IN 46805 | 2020-08-21 |
| 1710464086 | S.t.a.r. Care Services | Clinic/Center | 3521 Lake Avenue, Suite #4, Fort Wayne, IN 46805 | 2018-07-19 |
| 1083122865 | Noel Shafi | Counselor | 3010 East State Boulevard, Fort Wayne, IN 46805 | 2018-01-16 |
| 1063963627 | Toni L Irby | Specialist | 3219 E State Blvd, Fort Wayne, IN 46805 | 2016-10-19 |
| 1639626211 | Logan Schwerer | Pharmacist | 923 Northcrest Business Center 6d, Fort Wayne, IN 46805 | 2016-09-01 |
| 1063817104 | Michale Diane Rothgeb | Physical Therapy Assistant | 2200 Randollia Dr, Fort Wayne, IN 46805 | 2014-10-31 |
| 1124435789 | Julia I. Mcfann | Physical Therapist | 2200 Randalia Dr, Fort Wayne, IN 46805 | 2014-07-16 |
| 1083036974 | Capital Senior Living Properties 4, Inc. | Assisted Living Facility | 3320 East State Boulevard, Fort Wayne, IN 46805 | 2014-01-10 |
| 1356772396 | Alexander James Medical Supply | Durable Medical Equipment & Medical Supplies | 2200 Lake Avenue, Suite 290, Fort Wayne, IN 46805 | 2013-12-02 |
| 1043595689 | Randy James Jennings | Pharmacist | 923 Northcrest Business Center, 6-d, Fort Wayne, IN 46805 | 2011-10-14 |
| Find all providers in zip 46805 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982966255 | Kevin Harrington Ludwig | Dentist | 10211 Dupont Circle Dr W, Suite B, Fort Wayne, IN 46825-1622 | 2012-06-13 |
| 1619059557 | Timothy R Olinger | Dentist | 10211 Dupont Circle Drive West, Fort Wayne, IN 46825-1625 | 2006-10-19 |
| 1104859701 | Pediatric Dentistry Inc | Dentist | 7750 West Jefferson Blvd, Fort Wayne, IN 46804-4136 | 2006-07-08 |
| 1689185886 | Fort Wayne Pediatric Dentistry LLC | Dentist | 10211 Dupont Circle Dr W, Fort Wayne, IN 46825-1622 | 2017-10-16 |
| 1477678167 | Pediatric Dental Associates PC | Dentist | 7750 West Jefferson Blvd, Fort Wayne, IN 46804-4174 | 2007-03-20 |
| 1013016823 | James A Shupe Jr. | Dentist | 3030 Lake Ave, Suite 15, Fort Wayne, IN 46805-5428 | 2006-09-21 |
| 1407860216 | Wayne Lee Dawes | Dentist | 7750 W Jefferson Blvd, Fort Wayne, IN 46804-4174 | 2006-07-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477186732 | Poplar Pediatric Dentistry LLC | Dentist | 6741 Lexington Cir, Zionsville, IN 46077-9164 | 2020-02-14 |
| 1265074710 | Hendricks Pediatric Dentistry, LLC | Dentist | 1557 Windview, Brownsburg, IN 46112-7641 | 2019-10-16 |
| 1760048748 | Kids Dentistree of In, LLC | Dentist | 1602 W Mcclain Ave, Scottsburg, IN 47170-1161 | 2019-05-15 |
| 1134691090 | Dentistry Just for Kids and Orthodontics, LLC | Dentist | 1107 Ohio St, Terre Haute, IN 47807-3817 | 2018-12-17 |
| 1588159339 | Kids Dentistree of In, LLC | Dentist | 7900 E Us Highway 36 Ste K, Avon, IN 46123-7791 | 2018-06-25 |
| 1285128512 | Schulten Pediatric Dentistry - New Albany LLC | Dentist | 4317 Charlestown Rd, New Albany, IN 47150-8506 | 2018-06-20 |
| 1255843116 | John A. Bozc, D.d.s. PC | Dentist | 520 W Navajo St, West Lafayette, IN 47906-1999 | 2017-11-01 |
| 1316463607 | Emhardt Pediatric Dentistry LLC | Dentist | 1818 N Riley Hwy Ste B, Shelbyville, IN 46176-8572 | 2017-08-17 |
| 1194245225 | Sara Gholam | Dentist | 1121 W Michigan St Rm 280b, Indianapolis, IN 46202 | 2017-06-20 |
| 1245788066 | Eric Ladd, D.d.s. | Dentist | 555 W Us Highway 30, Schererville, IN 46375-2650 | 2016-09-21 |
| Find all providers with the same taxonomy | ||||
| City | FORT WAYNE |
| Zip Code | 46805 |
Please comment or provide details below to improve the information on JAMES A SHUPE DDS, DENTISTRY FOR CHILDREN, INC.
| 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.