Individual provider Active NPI

Wilma Shen, DDS

  • Dentist
  • Seattle, WA
National Provider Identifier
1447633987
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE60574167 Issued in WA
Practice address
4400 California Ave SW
Seattle, WA 98116-4109
Phone
(206) 935-6286
NPI assigned
Jul 1, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DE60574167 WA Primary

Addresses

Primary practice location

4400 California Ave SW
Seattle, WA 98116-4109

Mailing address

4400 California Ave SW
Seattle, WA 98116-4109
Phone (206) 935-6286

Other practice location 1

3216 NE 45th Pl Ste 302
Seattle, WA 98105-4028
Phone (206) 456-0550

Other practice location 2

2709 Bickford Ave Ste A
Snohomish, WA 98290-1766
Phone (425) 374-8451

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DE60574167WAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Cristina Kendall, DMD, PLLC CurrentSince Oct 22, 2023 Accepting new patients
Chet Jenkins III PC PastSince Aug 1, 2020 Accepting new patients
Laurelhurst Family Dentistry PastSince Aug 1, 2020 Accepting new patients
Dental Professionals of Washington Quirt Mongrain Gibree PC PastSince Jun 27, 2021 Accepting new patients
Hsu & Shao PLLC Dentist Past Accepting new patients

Locations

4400 California Ave SW
Seattle, WA 98116
Phone (206) 935-6286

Organizations & group practices 5

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": "1435708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1447633987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 CALIFORNIA AVE SW",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981164109",
            "telephone_number": "206-935-6286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 CALIFORNIA AVE SW",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981164109",
            "telephone_number": "206-935-6286"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3216 NE 45th Pl Ste 302",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981054028",
            "country_code": "US",
            "telephone_number": "206-456-0550",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2709 Bickford Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Snohomish",
            "state": "WA",
            "postal_code": "982901766",
            "country_code": "US",
            "telephone_number": "425-374-8451",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEN",
        "first_name": "WILMA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-01",
        "last_updated": "2023-03-07",
        "certification_date": "2023-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60574167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.