Shannon Marie Burdick, RDH

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

4840 Issued in CT

Practice address

2825 SW East Louise Cir
Port St Lucie, FL 34953-4273

Phone

(772) 871-6585

Fax

(561) 422-8595

NPI assigned

Sep 16, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Shannon Cunningham Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1221523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221523200000",
    "number": "1245489152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2825 SW EAST LOUISE CIRCLE",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "34953",
            "telephone_number": "772-871-6585",
            "fax_number": "561-422-8595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 SW EAST LOUISE CIR",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349534273",
            "telephone_number": "772-871-6585",
            "fax_number": "561-422-8595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURDICK",
        "first_name": "SHANNON",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-16",
        "last_updated": "2008-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "CT",
            "license": "4840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "CUNNINGHAM",
            "prefix": "MISS",
            "credential": "RDH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Paula Bryson, M.A.
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• Luden Bunch
• Stacy Adelle Burch, RBT
• Melinda Burdiss, PTA
• Tania Burey McLean, ARNP
• Paul Phillip Burgener, PT
• Jennifer Burgess, ARNP
• Jessica Burgos, RN

• Dental Hygienist in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Dental Hygienist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2008; 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.