Michael a. Shannon, D.D.S., M.S., Inc

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

MICHAEL A. SHANNON, D.D.S., M.S., INC

Practice address

206 Calle Potranca
San Clemente, CA 92672-4552

Phone

(949) 573-5654

NPI assigned

May 2, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Michael A. Shannon, D.D.S., M.S.NPI 1316168693

Title

President

Phone

(949) 573-5654

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael A. Shannon, D.D.S., M.S.

  • Pediatric Dentistry
  • Bakersfield, CA
  • NPI 1316168693
  NPD (past) Authorized official

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1437370707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 CALLE POTRANCA",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926724552",
            "telephone_number": "949-573-5654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 CALLE POTRANCA",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926724552",
            "telephone_number": "949-573-5654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL A. SHANNON, D.D.S., M.S., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHANNON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-573-5654",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S., M.S."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Veena Menda, M.D
• Janelle Anne Mercuro, RD
• Meighan Bartholomew Merono, PHARMD
• Mark Metildi, D.C.
• Metz-Schade Corp.
• Michael L Kreutz Chiropractic Inc
• Michelle Hannemann
• Chloe Nicole Miller, NATUROPATHIC DOCTOR
• Jennifer Lauren Miller
• Marlene Kae Mills-Margesson, LCSW

• Pediatric Dentistry in San Clemente, CA
• Providers in San Clemente, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.