DR. SHANE TERRY DAVIDSON (NPI# 1710208053) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710208053 |
| Entity Type | Individual |
| Full Name | DR. SHANE TERRY DAVIDSON |
| Credential | D.D.S. |
| Practice Address |
5574 Cooley Lake Road Waterford MI 48327 |
| Mailing Address |
297 Hershey Blvd Waterford MI 48327-2435 |
| Practice Telephone | 2489773006 |
| Mailing Telephone | 2488602031 |
| Mailing Fax Number | 2484996424 |
| Enumeration Date | 2010-06-22 |
| Last Update Date | 2015-08-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
2901020222 | MI | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083176390 | Shane Davidson | Chiropractor | 8601 S 30th St Ste 108, Lincoln, NE 68516-5957 | 2019-04-04 |
| Street Address |
5574 COOLEY LAKE ROAD |
| City | WATERFORD |
| State | MI |
| Zip Code | 48327 |
| 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 | 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 |
|---|---|---|---|---|
| 1891206421 | Travis Lynell Thomas | Dentist | 909 Hartford Tpke Ste D5, Waterford, CT 06385-4267 | 2017-10-23 |
| 1578083200 | Alexander Joseph Alkass | Dentist | 1132 Voorheis Rd, Waterford, MI 48328-3944 | 2017-06-23 |
| 1578916557 | Stephen Hendricks | Dentist | 5531 Brunswick Blvd, Waterford, MI 48327-2511 | 2016-07-14 |
| 1487900312 | Jeffrey W. Miller | Dentist | 5695 Dixie Hwy, Waterford, MI 48329-1619 | 2012-07-30 |
| 1144492067 | Wayne Eric Pickett | Dentist | 5574 Cooley Lake Rd, Waterford, MI 48327-3015 | 2008-04-01 |
| 1942496278 | Mark Laszlo, Dds, PC | Dentist | 4624 W Walton Blvd, Suite B, Waterford, MI 48329-3566 | 2007-09-20 |
| 1750501854 | Timothy Jm Kaercher | Dentist | 32 Broad Street, Waterford, NY 12188-2414 | 2007-04-30 |
| 1558586636 | George Lim Poy Jr. | Dentist | 7096 Highland Rd, Waterford, MI 48327-1502 | 2007-04-16 |
| 1427170034 | David A Wright | Dentist | 4152 Sashabaw Rd, Waterford, MI 48329-1953 | 2007-04-04 |
| 1043339427 | David James Mcchesney | Dentist | 5155 Dixie Hwy, Waterford, MI 48329-1715 | 2007-03-28 |
| Find all providers in WATERFORD | ||||
Please comment or provide details below to improve the information on DR. SHANE TERRY DAVIDSON.
| 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.