DR. CASEY RUSSELL SHEPHERD (NPI# 1720305741) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720305741 |
| Entity Type | Individual |
| Full Name | DR. CASEY RUSSELL SHEPHERD |
| Credential | D.M.D., M.D. |
| Practice Address |
180 Timberwolf Pkwy Kalispell MT 59901-1218 |
| Practice Telephone | 4067556014 |
| Practice Fax Number | 4067556094 |
| Mailing Telephone | 4067556014 |
| Mailing Fax Number | 4067556094 |
| Enumeration Date | 2010-04-30 |
| Last Update Date | 2020-09-09 |
| 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 |
11502 | MT | Dental Providers |
| N | 204E00000X | Oral & Maxillofacial Surgery | 11502 | MT | Allopathic & Osteopathic Physicians |
| Street Address |
180 TIMBERWOLF PKWY |
| City | KALISPELL |
| State | MT |
| Zip Code | 59901-1218 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912972662 | David M Weber | Dentist | 180 Timberwolf Pkwy, Kalispell, MT 59901-1218 | 2006-02-17 |
| 1962003616 | Kalispell Oral Surgery Center LLC | Oral & Maxillofacial Surgery | 180 Timberwolf Pkwy, Kalispell, MT 59901-1218 | 2020-11-07 |
| 1245855345 | David M Weber Dds Md PC | Dentist | 180 Timberwolf Pkwy, Kalispell, MT 59901-1218 | 2020-06-15 |
| 1326499310 | David M Weber Dds Md PC | Oral & Maxillofacial Surgery | 180 Timberwolf Pkwy, Kalispell, MT 59901-1218 | 2016-06-30 |
| 1063875946 | Joshua Blanton-dickens | Dentist | 180 Timberwolf Pkwy, Kalispell, MT 59901-1218 | 2016-03-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982226650 | Mountain Physical Therapy and Fitness Center LLC | Physical Medicine & Rehabilitation | 2593 Highway 2 East, Suite 6, Kalispell, MT 59901 | 2020-05-15 |
| 1164058350 | Jessica Leeann Abell | Physical Therapist | 1825 Highway 93 S. Suite C, Kalispell, MT 59901 | 2020-03-19 |
| 1588216535 | Diversified Therapeutic Services, Pllc | Clinic/Center | 30 E Washinton St, Suite A, Kalispell, MT 59901 | 2019-07-10 |
| 1467986216 | Jill Shaver | Counselor | 285 2nd Avenue Wn, Suite #100, Kalispell, MT 59901 | 2017-04-19 |
| 1003270810 | Angela Otto | Counselor | 17 2nd St E Ste 204, Kalispell, MT 59901 | 2016-04-07 |
| 1548626989 | Pamela Greskowiak | Counselor | 2282 Hwy 93 South, Suite #1, Kalispell, MT 59901 | 2016-01-14 |
| 1063894921 | Joel Booth | Dentist | 690 N Meridian Rd Ste 106, Kalispell, MT 59901 | 2015-06-26 |
| 1982085841 | Heather Reddig | Specialist | 751 Snowberry Trail, Kalispell, MT 59901 | 2015-06-16 |
| 1497147193 | Patricia Greene Hall | Psychologist | 1035 1st Ave W Fl 3, Kalispell, MT 59901 | 2015-03-04 |
| 1720478886 | Lori Mariani | Social Worker | 1605 Danielson Road, Kalispell, MT 59901 | 2015-01-28 |
| Find all providers in zip 59901 | ||||
| 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 |
|---|---|---|---|---|
| 1669662722 | James Jerman | Dentist | 60 Village Loop, Kalispell, MT 59901 | 2007-07-25 |
| 1912972662 | David M Weber | Dentist | 180 Timberwolf Pkwy, Kalispell, MT 59901-1218 | 2006-02-17 |
| 1245855345 | David M Weber Dds Md PC | Dentist | 180 Timberwolf Pkwy, Kalispell, MT 59901-1218 | 2020-06-15 |
| 1063875946 | Joshua Blanton-dickens | Dentist | 180 Timberwolf Pkwy, Kalispell, MT 59901-1218 | 2016-03-30 |
| 1538285887 | James B. Ronald | Dentist | 75 Claremont St, Suite D, Kalispell, MT 59901-3585 | 2007-03-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710523725 | Big Sky Oral & Facial Surgery | Dentist | 1125 W Kagy Blvd Ste 201, Bozeman, MT 59715-5879 | 2019-11-25 |
| 1528416963 | Lon Samuel Hinckley | Dentist | 152 S 32nd St W Ste B, Billings, MT 59102-6875 | 2016-05-26 |
| 1750678538 | Jesse Lane Gray | Dentist | 625 Herry Chapple St, Billings, MT 59106 | 2011-06-30 |
| 1265727150 | Jarom E. Maurer | Dentist | 4535 Valley Commons Dr Ste 102, Bozeman, MT 59718-4161 | 2011-06-20 |
| 1336301266 | Lance L Lerner | Dentist | 1994 Stadium Dr, Bozeman, MT 59715-0655 | 2008-07-01 |
| 1073656567 | Summit Oral Surgery and Implant Center | Dentist | 625 Henry Chapple, Billings, MT 59106 | 2007-02-14 |
| 1346337235 | Jason Howard Fleischmann | Dentist | 65 Medical Park Dr, Unit 1, Helena, MT 59601-8048 | 2006-10-10 |
| 1104934314 | Ronald E Neal | Dentist | 2714 15th Ave S, Great Falls, MT 59405-5246 | 2006-08-28 |
| 1588608616 | Richard Frederick John Holtzen IIi | Dentist | 805 S Reserve St, Missoula, MT 59801-2104 | 2006-06-16 |
| 1497394811 | Northern Montana Oral Surgery | Dentist | 2714 15th Ave S, Great Falls, MT 59405-5246 | 2020-01-02 |
| 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.