Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. JONATHAN DAVID SHADBURNE, DMD
DeactivatedDR. JONATHAN DAVID SHADBURNE, DMD is a Pediatric Dentistry healthcare provider located in GALLATIN, Tennessee. NPI 1861981979 is deactivated in the NPPES registry. Verify at CMS.
Pediatric Dentistry · GALLATIN, TN
This NPI has been deactivated.
The record was deactivated on October 4, 2023.
Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated.
Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.
Registration Details
- NPI Number
- 1861981979
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 3, 2018 (5.4207650273224 yrs)
- Last Updated
- Nov 15, 2023
- Deactivated
- Oct 4, 2023
- Licenses
-
30.025658 (OH)11282 (TN)
Practice Information
- Address
-
124 GOODVIEW WAY STE BGALLATIN, TN, 370664927Browse TN providers · Browse ZIP 37066
- Phone
- 6155753344
- Primary Specialty
-
Pediatric Dentistry
1223P0221X
- Additional Specialty
- Student (Health Education/Training)
- Additional Specialty
- Pediatric Dentistry
Other Pediatric Dentistry Providers in GALLATIN, TN
| Name | Credential | NPI |
|---|---|---|
| DR. JAMES ANDREW REED | DDS, MSD | 1013161041 |
| DR. BORA KIM | DMD | 1437686920 |
| SAMANTHA JO KELLY | — | 1255852661 |
| DR. TYLER FIELDING MCCUBBINS | DMD | 1447743653 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.