Provider Demographics
NPI:1780704478
Name:SHOEMAKER, JOHN T (DDS)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:T
Last Name:SHOEMAKER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1609 N HWY 75
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75090-5165
Mailing Address - Country:US
Mailing Address - Phone:903-893-7751
Mailing Address - Fax:903-862-6570
Practice Address - Street 1:1609 N HWY 75
Practice Address - Street 2:SUITE 300
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090-5165
Practice Address - Country:US
Practice Address - Phone:903-893-7751
Practice Address - Fax:903-862-6570
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX129051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX751987780OtherDENTAL