JACK C SHADER DDS PC
NPI 1912000977
Dentist - General Practice in Clarkston, MI

Q: What is Jack C Shader Dds PC's NPI number?

The NPI number for Jack C Shader Dds PC is 1912000977. It was assigned to this organization in the NPPES registry on September 6, 2006.

Q: What is Jack C Shader Dds PC's specialty?

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

Active since September 06, 2006

6300 SASHABAW RD, STE A, CLARKSTON, MI 48436(248) 625-9444(248) 625-4813 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 23, 2026.

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About Jack C Shader Dds Pc NPPES

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

JACK C SHADER DDS PC (NPI 1912000977) is a healthcare organization registered as a general practice in Clarkston, Michigan and active in the NPI registry since September 2006. The organization lists Jack C Shader, President, as its authorized official.

NPPES Registry Identity

NPI1912000977

Entity TypeOrganization

Primary Taxonomy1223G0001X

Legal Business NameJACK C SHADER DDS PC

Location Address6300 SASHABAW RD, STE AClarkston, MI 48436

Mailing Address6300 Sashabaw Rd, Ste AClarkston, MI 48436 · (248) 625-9444 · Fax (248) 625-4813

Phone(248) 625-9444

Fax(248) 625-4813

Organization SubpartNo

Authorized OfficialJack C ShaderPresident · (248) 625-9444

Enumeration DateSeptember 6, 2006

Last NPPES UpdateAugust 22, 2020

✔ NPI 1912000977 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 · 11126

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.

6300 SASHABAW RD, Clarkston, MI 48436

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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

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 Jack C Shader Dds PC's NPI number?

The NPI number for Jack C Shader Dds PC is 1912000977. It was assigned to this organization in the NPPES registry on September 6, 2006.

Where is Jack C Shader Dds PC located?

Jack C Shader Dds PC is located at 6300 Sashabaw Rd Ste A, Clarkston, MI 48436. The listed phone number is (248) 625-9444.

What is Jack C Shader Dds PC's specialty?

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

When was this NPI record last updated?

The NPPES record for Jack C Shader Dds PC was last updated on August 22, 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.