Individual provider Active NPI

Shannika Tricia Dao, D.D.S

  • Dentist
  • Redding, CA
National Provider Identifier
1275828840
Registry record updated Sep 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
64200 Issued in CA
Practice address
2695 Bechelli LN
Redding, CA 96002
Phone
(530) 222-4900
NPI assigned
Jun 13, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 056205 NY
Dentist 122300000X 64200 CA Primary

Addresses

Primary practice location

2695 Bechelli LN
Redding, CA 96002

Mailing address

2695 Bechelli LN
Redding, CA 96002-0926
Phone (530) 222-4900

Other practice location 1

1012 4th St
Yreka, CA 96097
Phone (530) 842-4592

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160728001862 CA Order and Referring Only - Other (Non-Physician) 7618260621

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
056205NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Shannika Dao DDS Inc. CurrentSince Sep 25, 2019 Accepting new patients

Locations

2695 Bechelli Ln
Redding, CA 96002
Phone (530) 222-4900

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1307923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568678400000",
    "number": "1275828840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2695 BECHELLI LN",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960020926",
            "telephone_number": "530-222-4900",
            "fax_number": "530-842-2704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2695 BECHELLI LN",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "96002",
            "telephone_number": "530-222-4900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1012 4th St",
            "address_purpose": "LOCATION",
            "city": "Yreka",
            "state": "CA",
            "postal_code": "96097",
            "country_code": "US",
            "telephone_number": "530-842-4592",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAO",
        "first_name": "SHANNIKA",
        "middle_name": "TRICIA",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-13",
        "last_updated": "2019-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "056205",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "64200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

Verify at the official NPI Registry.