Shannon K Carter, RDH
Individual provider Active NPI Dental Hygienist · Kimball, MI
NPI 1245713601 · NPPES record last updated Sep 12, 2018
Key facts
- NPI
- 1245713601
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dental Hygienist 124Q00000X
- License
- 2902012674 (MI)
- Practice address
- 2837 Stable Dr Ste a
Kimball, MI 48074-1441 - Phone
- (810) 985-3301
- Fax
- (855) 747-1702
- NPI assigned
- Sep 12, 2018
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2902012674 | MI | MD | Dental Hygienist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Scott J. Ferguson DDS & Associates PLLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 2902012674 | MI | Yes |
Addresses
Primary practice location
2837 Stable Dr Ste a
Kimball, MI 48074-1441
Mailing address
2837 Stable Dr Ste a
Kimball, MI 48074-1441
Other providers in Kimball, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 12, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.