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DR. ROCK TYLER SHADDUCK DMD
NPI 1124642392
Dentist - General Practice in Wyncote, PA

Active since June 03, 2020
1000 EASTON RD STE 465, WYNCOTE, PA 19095(267) 367-5014 Get Directions Write a Review

NPPES record last updated: June 3, 2020. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Dr. Rock Tyler Shadduck Dmd NPPES

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

DR. ROCK TYLER SHADDUCK DMD (NPI 1124642392) is an individual general practice provider in Wyncote, Pennsylvania, licensed in Pennsylvania (DS042686) and active in the NPI registry since June 2020.

NPPES Registry Identity

NPI1124642392
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameDR. ROCK TYLER SHADDUCKCredential: DMD
Location Address1000 EASTON RD STE 465Wyncote, PA 19095-2900
Mailing Address633 W Rittenhouse St Apt B302Philadelphia, PA 19144-4363 · (607) 425-2720
Phone(267) 367-5014
Sole ProprietorYes
Enumeration DateJune 3, 2020
NPPES CertifiedJune 3, 2020
✔ NPI 1124642392 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in PA · DS042686
Definition
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.
1000 EASTON RD STE 465, Wyncote, PA 19095
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

Other Providers at the Same Location NPPES 2

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

DR. SURAJ SINGH BHOGAL DMD
Dentist
1000 EASTON RD STE 465
WYNCOTE, PA 19095
Montgomery County (732) 609-2344
DR. QUINCY WANG DDS
Dentist
1000 EASTON RD STE 465
WYNCOTE, PA 19095
Montgomery County (267) 367-5014

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 Rock Shadduck's NPI number?

The NPI number for Rock Shadduck is 1124642392. It was assigned to this individual provider in the NPPES registry on June 3, 2020.

Where is Rock Shadduck located?

Rock Shadduck practices at 1000 Easton Rd Ste 465, Wyncote, PA 19095. The listed phone number is (267) 367-5014.

What is Rock Shadduck's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

What insurance does Rock Shadduck accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and Humana list Rock Shadduck as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Rock Shadduck was last updated on June 3, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.