Shawn K Wilson DDS Inc

Primary specialty

DentistTaxonomy code 122300000X

License

032518 Issued in CA

Legal business name

SHAWN K WILSON DDS INC

Practice address

3110 Churn Creek Road
Redding, CA 96002

Phone

(530) 222-0515

Fax

(530) 222-1623

NPI assigned

Oct 23, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Shawn Kevin Wilson, DDS

Title

Owner Operator

Phone

(530) 222-0515

Specialties & licenses 1

Addresses

Other names 1

• Shawn K Wilson DDS Former legal business name

Locations

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412208000000",
    "number": "1477636280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3110 CHURN CREEK ROAD",
            "address_2": "SUITE A",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "96002",
            "telephone_number": "530-222-0515",
            "fax_number": "530-222-1623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3110 CHURN CREEK ROAD",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "96002",
            "telephone_number": "530-222-0515",
            "fax_number": "530-222-1623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAWN K WILSON DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2014-10-02",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_middle_name": "KEVIN",
        "authorized_official_title_or_position": "OWNER OPERATOR",
        "authorized_official_telephone_number": "530-222-0515",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "032518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shawn K Wilson DDS",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Jill Ann Shaw, MD
• Patricia Louise Shaw, LMFT
• Shawn P. Guerin, DDS Dental Corporation (Redding Dental Group)
• Brandy Shedd, PHARMD
• Rhonda Lynn Shelburne, RN
• Shelby Lou Casey (Shasta Speech and Language)
• Thomas E. Shellenberger, PA

• Dentist in Redding, CA
• Providers in Redding, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2014; 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.