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NPI Code Detail

MEDICARE: DR. SHAWN M BADER DDS, MS

MEDICARE: DR. SHAWN M BADER DDS, MS
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
1122300000XDentist7329KY
21223X0400XOrthodontics and Dentofacial Orthopedics Dentistry5242AZ

General Provider Information

NPI Number : 1366408668
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHAWN M BADER DDS, MS
Provider Business Mailing Address
First Line : 8890 E DESERT COVE AVE
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85260-6746
Country : US
Telephone Number : 480-661-1818
Fax Number : 480-661-0699
Provider Business Practice Location Address
First Line : 8890 E DESERT COVE AVE
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85260-6746
Country : US
Telephone Number : 480-661-1818
Fax Number : 480-661-0699
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2006
Last Update Date : 12/03/2014

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