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DR. SHANE TERRY DAVIDSON D.D.S.
NPI 1710208053
Dentist - General Practice in West Bloomfield, MI

Active since June 22, 2010PECOS Enrolled
7805 COOLEY LAKE RD STE 400, WEST BLOOMFIELD, MI 48324(248) 977-3006(248) 242-6762 Get Directions Write a Review

NPPES record last updated: August 8, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Dr. Shane Terry Davidson D.d.s. NPPES

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

DR. SHANE TERRY DAVIDSON D.D.S. (NPI 1710208053) is an individual general practice provider in West Bloomfield, Michigan, licensed in Michigan (2901020222) and active in the NPI registry since June 2010. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1710208053
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameDR. SHANE TERRY DAVIDSONCredential: D.D.S.
Location Address7805 COOLEY LAKE RD STE 400West Bloomfield, MI 48324-3535
Mailing Address297 Hershey BlvdWaterford, MI 48327-2435 · (248) 860-2031 · Fax (248) 499-6424
Phone(248) 977-3006
Fax(248) 242-6762
Sole ProprietorYes
Enumeration DateJune 22, 2010
Last NPPES UpdateAugust 8, 2023
NPPES CertifiedMay 31, 2022
✔ NPI 1710208053 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in MI · 2901020222
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.

7805 COOLEY LAKE RD STE 400, West Bloomfield, MI 48324
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Shane Terry Davidson D.d.s. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48324 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$90.76 typical visit price
range $58.04 – $177.36
Typical copayment $22.69 (range $14.51 – $44.34)
Most-billed visit code 99203
Established Patient
$72.38 typical visit price
range $18.32 – $143.49
Typical copayment $18.09 (range $4.58 – $35.87)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Shane Davidson's NPI number?

The NPI number for Shane Davidson is 1710208053. It was assigned to this individual provider in the NPPES registry on June 22, 2010.

Where is Shane Davidson located?

Shane Davidson practices at 7805 Cooley Lake Rd Ste 400, West Bloomfield, MI 48324. The listed phone number is (248) 977-3006.

What is Shane Davidson's specialty?

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

Is Shane Davidson enrolled in Medicare?

Yes. Shane Davidson is registered in the Medicare PECOS enrollment system.

What insurance does Shane Davidson accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and BEST Life and 14 other insurers list Shane Davidson 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 Shane Davidson was last updated on August 8, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.