MEDICARE: L DON SHUMAKER DDS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	30012767	OH

General Provider Information

NPI Number	:	1174681696
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	L DON SHUMAKER DDS INC

Provider Business Mailing Address
First Line	:	1801 E 12TH ST
Second Line	:	#222
City	:	CLEVELAND
State	:	OH
Zip	:	44114-3526
Country	:	US
Telephone Number	:	216-621-1953
Fax Number	:	216-472-0145

Provider Business Practice Location Address
First Line	:	1801 E 12TH ST
Second Line	:	#222
City	:	CLEVELAND
State	:	OH
Zip	:	44114-3526
Country	:	US
Telephone Number	:	216-621-1953
Fax Number	:	216-472-0145

Authorized Official
Title or Position	:	OWNER
Name	:	DR. LLOYD DON SHUMAKER
Credential	:	DDS
Telephone Number	:	216-621-1953

Provider Enumeration Date	:	12/05/2006
Last Update Date	:	08/22/2020

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