Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Shane Terry Davidson, DDS

Individual provider General Practice Dentistry · NPI 1710208053

Dr. Shane Terry Davidson, DDS is a General Practice Dentistry in West Bloomfield, Michigan. Practices as a sole proprietor. Licensed in Michigan.

Licensed in
MI
In the registry since
2010
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

7805 Cooley Lake Rd Ste 400
West Bloomfield, MI 48324-3535
Phone: (248) 977-3006
Fax: (248) 242-6762
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 2901020222 (MI)

Record details

NPI number1710208053
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorYes
NPI enumeratedJune 22, 2010
Last updated in NPPESAugust 8, 2023
Certification dateMay 31, 2022
Mailing address297 Hershey Blvd, Waterford, MI 48327-2435

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