Active NPI
Shannon Davis, RDH
- Dental Hygienist
- Phoenix, AZ
National Provider Identifier
1477703932
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 6071
- Practice address
- 4212 N 16TH St
Phoenix, AZ 85016 - Phone
- (602) 263-1200
- NPI assigned
- Sep 22, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 6071 | AZ | Primary |
Addresses
Primary practice location
4212 N 16TH St
Phoenix, AZ 85016
Mailing address
PO Box 31001-0698
Pasadena, CA 91110-0698
Phone (602) 263-1200
Other practice location 1
167 North Main Street
Tuba City, AZ 86045-0600
Phone (928) 283-2501 ext. 2002
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6071 | AZ | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222041600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569196800000",
"number": "1477703932",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 31001-0698",
"city": "PASADENA",
"state": "CA",
"postal_code": "911100698",
"telephone_number": "602-263-1200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4212 N 16TH ST",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "85016",
"telephone_number": "602-263-1200"
}
],
"practiceLocations": [
{
"address_1": "167 North Main Street",
"address_purpose": "LOCATION",
"city": "Tuba City",
"state": "AZ",
"postal_code": "860450600",
"country_code": "US",
"telephone_number": "928-283-2501 x2002",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DAVIS",
"first_name": "SHANNON",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-09-22",
"last_updated": "2019-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "AZ",
"license": "6071",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.