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JOHN SHEA D.D.S. LLC NPI 1942470331


NPI Information

NPI: 1942470331
Provider Name: JOHN SHEA D.D.S. LLC
Classification: Dentist - 1223P0221X
Entity Type: Organization

Specialization: Pediatric Dentistry

Address:
615 10TH ST S
LA CROSSE, WI
ZIP 54601
Phone: (608) 782-4054
Get Directions

JOHN SHEA D.D.S. LLC is a pediatric dentistry dentist in La Crosse, WI. The provider is 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. JOHN SHEA D.D.S. LLC NPI is 1942470331. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

615 10TH ST S
LA CROSSE, WI
ZIP 54601-768
Phone: (608) 782-4054
Fax: (608) 782-2198

The provider's authorized official is John V.e. Shea .
The authorized official title is Owner and has the following contact phone number (608) 782-4054.

The enumeration date for this NPI number is 3/3/2008 and was last updated on 3/3/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223P0221XDentistPediatric DentistryWISCONSINYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
133463300MEDICAIDWISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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