Shannon Murray Wilson, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE61287908 Issued in WA

Practice address

142 N 83Rd St
Seattle, WA 98103-4208

Phone

(206) 920-5430

NPI assigned

Jul 8, 2022

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Shannon Wilson DDS PS

  • Dental Clinic/Center
  • Seattle, WA
  • NPI 1710794979
  NPD Authorized official

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

{
    "created_epoch": "1657238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657238400000",
    "number": "1255064952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 N 83RD ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981034208",
            "telephone_number": "206-920-5430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 N 83RD ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981034208",
            "telephone_number": "206-920-5430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SHANNON",
        "middle_name": "MURRAY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-08",
        "last_updated": "2022-07-08",
        "certification_date": "2022-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE61287908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert F Wilson, MD
• Robin K Wilson, LMT
• Ruby Dodge Stone Wilson, OTR/L
• Ryan Wilson, OT
• Ryan Blake Wilson, BA, AAC
• Shira Beth Wilson, M.A., LMHC
• Stephanie M Wilson, LMP
• Suzan Rood Wilson, LMFT
• Suzanne K. Wilson, CNM, ARNP
• Thomas John Wilson, M.D.

• General Practice Dentistry in Seattle, WA
• Providers in Seattle, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2022; 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.