Shawn Elizabeth Wild

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

18779 Issued in CA

Practice address

10602 Chapman Ave Ste 200
Garden Grove, CA 92840-3147

Phone

(714) 537-7900

NPI assigned

Oct 23, 2017

Last updated

Oct 23, 2017By the provider in NPPES

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

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

{
    "created_epoch": "1508716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508716800000",
    "number": "1255842720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 FORD LN",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "928705500",
            "telephone_number": "562-743-4126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10602 CHAPMAN AVE STE 200",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928403147",
            "telephone_number": "714-537-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILD",
        "first_name": "SHAWN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-23",
        "last_updated": "2017-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "CA",
            "license": "18779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah M Whiteside
• Shelby Taylor Whitney
• Marcus Whittenberg
• Jason Satria Wiguna, DO
• Zoe Wilcoxson
• Mikhayla Desiree Wilkins
• Camille Ashley Wilkinson
• Konita Lee Wilks, D.D.S.
• William Park, M.D., Inc
• Jasmine Williams McCane, BT

• Dental Hygienist in Garden Grove, CA
• Providers in Garden Grove, CA by specialty
• Dental Hygienist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2017; 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.