Individual provider Active NPI

Shawn S Faddir, RDH

  • Dental Hygienist
  • Plano, TX
National Provider Identifier
1467577601
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
10815 Issued in TX
Practice address
6841 Coit Rd
Plano, TX 75024-5417
Phone
(972) 618-5000
Fax
(972) 618-9369
NPI assigned
Mar 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 10815 TX Primary

Addresses

Primary practice location

6841 Coit Rd
Plano, TX 75024-5417

Mailing address

5100 Verde Valley LN
#165
Dallas, TX 75254
Phone (214) 499-8843

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
10815TXMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Steven P Thompson DDS PA Past Accepting new patients
TX Southern Dental PPO PC PastSince Oct 25, 2020 Accepting new patients

Organizations & group practices 2

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": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467577601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 VERDE VALLEY LN",
            "address_2": "#165",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75254",
            "telephone_number": "214-499-8843",
            "fax_number": "972-618-9369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6841 COIT RD",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750245417",
            "telephone_number": "972-618-5000",
            "fax_number": "972-618-9369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FADDIR",
        "first_name": "SHAWN",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "TX",
            "license": "10815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.