Provider Demographics
NPI:1750409579
Name:SHEMEN DENTAL GROUP, LLP
Entity type:Organization
Organization Name:SHEMEN DENTAL GROUP, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:SAUER
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:806-358-2472
Mailing Address - Street 1:9 CARE CIR
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79124-2105
Mailing Address - Country:US
Mailing Address - Phone:806-358-2472
Mailing Address - Fax:
Practice Address - Street 1:9 CARE CIR
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79124-2105
Practice Address - Country:US
Practice Address - Phone:806-358-2472
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2011-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6523990001Medicare NSC