Whalio Doctors

NPI 1013016823

James a Shupe, DDS

Practitioner Pediatric Dentistry Fort Wayne, IN

Practice location

Address
3030 Lake Ave Suite 15, Fort Wayne, IN 46805-5428
Phone
(260) 422-8419
Fax
(260) 422-3591

Registered specialties

Pediatric Dentistry Primary
Dental Providers Taxonomy 1223P0221X Licence 12008822A (IN)

Registry record

NPI
1013016823
Entity type
Individual
Sex (as registered)
Male
NPI issued
21 Sep 2006
Record last updated
8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.