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SHATTUCK DENTISTRY & BRACES
NPI 1114449394
Dentist in Shattuck, OK

Active since July 10, 2017
1523 S MAIN ST, SHATTUCK, OK 73858(580) 938-2566(580) 938-2567 Get Directions Write a Review

NPPES record last updated: October 29, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 29, 2020, Aug 25, 2020, Jul 10, 2017 (3 updates tracked since 2017).

About Shattuck Dentistry & Braces NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHATTUCK DENTISTRY & BRACES (NPI 1114449394) is a healthcare organization registered as a dentist in Shattuck, Oklahoma and active in the NPI registry since July 2017. The organization lists Benjamin James Bowman, Manager, as its authorized official.

NPPES Registry Identity

NPI1114449394
Entity TypeOrganization
Primary Taxonomy122300000X
Legal Business NameSHATTUCK DENTISTRY & BRACES
Location Address1523 S MAIN STShattuck, OK 73858-9223
Mailing Address1523 S. MainShattuck, OK 73858 · (580) 938-2566 · Fax (580) 938-2567
Phone(580) 938-2566
Fax(580) 938-2567
Organization SubpartNo
Authorized OfficialBenjamin James BowmanManager · (405) 326-8004
Enumeration DateJuly 10, 2017
Last NPPES UpdateOctober 29, 20203 updates tracked since enumeration
NPPES CertifiedOctober 29, 2020
✔ NPI 1114449394 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
1523 S MAIN ST, Shattuck, OK 73858
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Other Identifiers 1

Medicaid1205032935OK

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NEWMAN MEMORIAL HOSPITAL, INC.
Clinic/Center (Critical Access Hospital)
1523 S MAIN ST
SHATTUCK, OK 73858
Ellis County (580) 938-2551

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shattuck Dentistry & Braces's NPI number?

The NPI number for Shattuck Dentistry & Braces is 1114449394. It was assigned to this organization in the NPPES registry on July 10, 2017.

Where is Shattuck Dentistry & Braces located?

Shattuck Dentistry & Braces is located at 1523 S Main St, Shattuck, OK 73858. The listed phone number is (580) 938-2566.

What is Shattuck Dentistry & Braces's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

When was this NPI record last updated?

The NPPES record for Shattuck Dentistry & Braces was last updated on October 29, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.