Richard A. Shockley, D.D.S.

General Practice Dentistry · Portage, MI

Individual Active NPI

NPI number 1194775502

Practice location

706 W Centre Ave
Portage, MI 49024-5310
Phone
(269) 323-1679
Fax
(269) 323-1536

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NPI record

NPI
1194775502
Entity type
Individual (Type 1)
Enumeration date
May 10, 2006
Last updated
March 23, 2012
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
General Practice Dentistry Primary 1223G0001X 2901011400 MI

About Dr. Shockley

Richard A. Shockley, D.D.S. is a healthcare provider registered in the NPI registry with the primary taxonomy General Practice Dentistry (code 1223G0001X). The practice location is 706 W Centre Ave, Portage, MI 49024-5310. The NPI number 1194775502 was assigned on May 10, 2006 and the record was last updated on March 23, 2012.

Dr. Shockley lists a license in the registry: #2901011400 (MI) for General Practice Dentistry. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Richard A. Shockley, D.D.S.?

The NPI number is 1194775502.

What is the phone number of Dr. Shockley?

The phone number listed for the practice location is (269) 323-1679.

Where is Dr. Shockley located?

706 W Centre Ave, Portage, MI 49024-5310.

What is the taxonomy code for Dr. Shockley?

The primary taxonomy code is 1223G0001X – General Practice Dentistry.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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