Ken Shanahan, D.D.S., M.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

57940 Issued in CA

Practice address

3434 Villa LN
Suite 110
Napa, CA 94558-6405

Phone

(707) 255-0555

Fax

(707) 255-8172

NPI assigned

Oct 11, 2011

Last updated

Feb 13, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Interoperability endpoints

• Direct secure messaging: kshanahan@direct.westerndental.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Up Valley Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Saint Helena, CA
  • NPI 1225485691
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1318291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329091200000",
    "number": "1174808067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3434 VILLA LN",
            "address_2": "SUITE 110",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945586405",
            "telephone_number": "707-255-0555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3434 VILLA LN",
            "address_2": "SUITE 110",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945586405",
            "telephone_number": "707-255-0555",
            "fax_number": "707-255-8172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANAHAN",
        "first_name": "KEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-11",
        "last_updated": "2012-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "57940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maureen Helen Seydel, HIS
• Jordan Shaffer, CMT
• Tami Lynn Shaffer
• Rutul Shah
• Mahnaz Shahidi-Asl, MD
• Elizabeth Shane, M.D.
• Sky Patrice Shanks, D.P.M.
• Suhani Sharda
• Marla Shauer, CNM
• Kimberly Shaul, FNP

• Orthodontics and Dentofacial Orthopedics Dentistry in Napa, CA
• Providers in Napa, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.