Provider Demographics
NPI:1356457352
Name:STEPHEN E. SHPEEN, DMD, LLC
Entity Type:Organization
Organization Name:STEPHEN E. SHPEEN, DMD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHPEEN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:856-988-0023
Mailing Address - Street 1:546 LIPPINCOTT DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4807
Mailing Address - Country:US
Mailing Address - Phone:856-988-0023
Mailing Address - Fax:856-088-1203
Practice Address - Street 1:546 LIPPINCOTT DR
Practice Address - Street 2:SUITE A
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-4807
Practice Address - Country:US
Practice Address - Phone:856-988-0023
Practice Address - Fax:856-088-1203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI014001001223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty