Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1710208053 Individual Practitioner Male Practitioner

Dr. Shane Terry Davidson , DDS

Dentist - General Practice • West Bloomfield, MI

Professional Overview & Biography Verified Profile Summary

Dr. Shane Davidson, DDS is a registered healthcare professional specializing in Dentist - General Practice in West Bloomfield, MI. Practice services are available at 7805 COOLEY LAKE RD STE 400 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

7805 Cooley Lake Rd Ste 400

West Bloomfield, MI 483243535

Telephone 2489773006
Fax 2482426762
Associated Practice Facility / Clinic
🏢 Shane Davidson Dds Pc Facility NPI 1033651427

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in West Bloomfield, MI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 15.8 Yrs
Regional Practice Density
42 Specialists

Practicing in West Bloomfield, MI (4360 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2022-05-31
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License MI 2901020222

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
📍
Updated Practice Location August 08, 2023

Registered at 7805 COOLEY LAKE RD STE 400, WEST BLOOMFIELD, MI 483243535 (Tel: 2489773006)

NPI Profile Active August 19, 2015

NPI status registered as active in NPPES database

📍
Updated Practice Location August 19, 2015

Registered at 5574 COOLEY LAKE ROAD, WATERFORD, MI 48327 (Tel: 2489773006)

📍
Updated Business Mailing Address August 19, 2015

Registered at 297 HERSHEY BLVD, WATERFORD, MI 483272435 (Tel: 2488602031)

👤
Provider Name / Credentials Updated August 19, 2015

Recorded as SHANE DAVIDSON, D.D.S.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 19, 2015

Dentist (License #2901020222 in MI)

🟢
Initial NPI Registration & Enumeration June 22, 2010

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1710208053
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 22, 2010
Last Update: August 08, 2023
Sole Proprietor: Yes

Mailing Address

297 Hershey Blvd

Waterford, MI 483272435

Phone: 2488602031

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.