Provider Demographics
NPI:1851412472
Name:SHOBE, CHAD E (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:E
Last Name:SHOBE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 ARLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614
Mailing Address - Country:US
Mailing Address - Phone:419-383-3805
Mailing Address - Fax:
Practice Address - Street 1:3000 ARLINGTON AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614
Practice Address - Country:US
Practice Address - Phone:419-383-3805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22801122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1479404-03Medicaid
TX1479404-10Medicaid
TX1479404-01Medicaid
TX1479404-09Medicaid
TX1804726-02Medicaid
TX1804726-04Medicaid
TX1479404-11Medicaid
TX1804726-03Medicaid
TX1479404-12Medicaid
TX1479404-04Medicaid
TX1479404-05Medicaid
TX1479404-07Medicaid
TX1479404-08Medicaid
TX1804726-01Medicaid
TX1479404-06Medicaid