Provider Demographics
NPI:1942375373
Name:SHAKESPEAR, KERRY DANNY (DMD)
Entity Type:Individual
Prefix:DR
First Name:KERRY
Middle Name:DANNY
Last Name:SHAKESPEAR
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:516 W ARAPAHO RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-4358
Mailing Address - Country:US
Mailing Address - Phone:972-231-5020
Mailing Address - Fax:972-231-5950
Practice Address - Street 1:516 W. ARAPAHO RD
Practice Address - Street 2:#103
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080
Practice Address - Country:US
Practice Address - Phone:972-231-5020
Practice Address - Fax:972-231-5950
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV51181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice