Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1124642392 Individual Practitioner Male Practitioner

Dr. Rock Tyler Shadduck , DMD

Dentist - General Practice • Wyncote, PA

Professional Overview & Biography Verified Profile Summary

Dr. Rock Shadduck, DMD is a registered healthcare professional specializing in Dentist - General Practice in Wyncote, PA. Practice services are available at 1000 EASTON RD STE 465 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1000 Easton Rd Ste 465

Wyncote, PA 190952900

Telephone 2673675014

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Wyncote, PA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 19.0 Yrs
Regional Practice Density
2 Specialists

Practicing in Wyncote, PA (4936 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: 2020-06-03
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License PA DS042686

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners
NPI 1114413135

Doctor of Dental Medicine

Dr. Victoria Galenas , DMD

Dentist - General Practice

NPI 1538848189

Doctor of Dental Medicine

NPI 1568031839

Doctor of Dental Surgery

Career & Practice History Timeline

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

6 Historical Events
NPI Profile Active June 03, 2020

NPI status registered as active in NPPES database

📍
Updated Practice Location June 03, 2020

Registered at 1000 EASTON RD STE 465, WYNCOTE, PA 190952900 (Tel: 2673675014)

📍
Updated Business Mailing Address June 03, 2020

Registered at 633 W RITTENHOUSE ST APT B302, PHILADELPHIA, PA 191444363 (Tel: 6074252720)

👤
Provider Name / Credentials Updated June 03, 2020

Recorded as ROCK SHADDUCK, DMD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 03, 2020

Dentist (License #DS042686 in PA)

🟢
Initial NPI Registration & Enumeration June 03, 2020

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: 1124642392
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 03, 2020
Last Update: June 03, 2020
Sole Proprietor: Yes

Mailing Address

633 W Rittenhouse St Apt B302

Philadelphia, PA 191444363

Phone: 6074252720

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.