Provider Demographics
NPI:1043355035
Name:SHUMPERT, WILLIAM OCELL JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:OCELL
Last Name:SHUMPERT
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:WILLIAM OCELL
Other - Middle Name:OCELL
Other - Last Name:SHUMPERT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DENTIST
Mailing Address - Street 1:2885 PLAYER CT
Mailing Address - Street 2:
Mailing Address - City:TITUSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32780-4867
Mailing Address - Country:US
Mailing Address - Phone:954-560-2094
Mailing Address - Fax:
Practice Address - Street 1:2885 PLAYER CT
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32780-4867
Practice Address - Country:US
Practice Address - Phone:954-560-2094
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2013-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLD6457122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist