Healthcare Provider Details

I. General information

NPI: 1235417114
Provider Name (Legal Business Name): JOHN CHRISTIAN MCSHANE D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2011
Last Update Date: 07/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3909 WASHINGTON RD SUITE 310
MC MURRAY PA
15317-2544
US

IV. Provider business mailing address

3909 WASHINGTON RD SUITE 310
MC MURRAY PA
15317-2544
US

V. Phone/Fax

Practice location:
  • Phone: 724-941-5272
  • Fax: 724-942-3231
Mailing address:
  • Phone: 724-941-5272
  • Fax: 724-942-3231

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDS038826
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: