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James A Shupe JR., DDS
Pediatric Dentist in Fort Wayne, Indiana
NPI 1013016823

James A Shupe JR. is a Pediatric Dentist based in Fort Wayne, IN and is specialized in Pediatric Dentistry. James A Shupe JR. practices in Fort Wayne, IN and has the professional credentials of DDS. The NPI Number for James A Shupe JR. is 1013016823 and holds a License No. 12008822A (Indiana).

The current practice location address for James A Shupe JR. is 3030 Lake Ave, Fort Wayne, IN and can be reached out via phone at 260-422-8419 and via fax at 260-422-3591. You can also correspond with James A Shupe JR. through the mailing address at 3030 LAKE AVE, FORT WAYNE, IN - 46805-5428 (mailing address contact number: 260-422-8419).

Location: 3030 Lake Ave, Fort Wayne, IN, 46805-5428
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1013016823
Provider Name
James A Shupe JR.
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
3030 Lake Ave, Fort Wayne, IN, 46805-5428
Phone Number
260-422-8419
Fax Number
260-422-3591
Provider Enumeration Date
09/21/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
3030 Lake Ave
City
Fort Wayne
State
Indiana
Zip
46805-5428
Phone Number
260-422-8419
Fax Number
260-422-3591
person
Provider Business Mailing Address Details
Address
3030 Lake Ave
City
Fort Wayne
State
Indiana
Zip
46805-5428
Phone Number
260-422-8419
Fax Number
260-422-3591
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
12008822A (Indiana)
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
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