Provider Demographics
NPI:1659492155
Name:SHEAFFER, JOHN CHRISTIAN (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:CHRISTIAN
Last Name:SHEAFFER
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:2310 MYRON DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-3358
Mailing Address - Country:US
Mailing Address - Phone:919-782-8603
Mailing Address - Fax:919-782-1295
Practice Address - Street 1:2310 MYRON DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-3358
Practice Address - Country:US
Practice Address - Phone:919-782-8603
Practice Address - Fax:919-782-1295
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC66031223E0200X
PA04-2508201223E0200X
KY76751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1223E0200XDental ProvidersDentistEndodontics
Not Answered1223G0001XDental ProvidersDentistGeneral Practice