Shannon Dryer, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D-4964 Issued in ID

Practice address

2344 N Merritt Creek Loop
Coeur D Alene, ID 83814

Phone

(208) 676-8500

NPI assigned

Jun 13, 2014

Last updated

Sep 17, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Riverstone Dental Care

  • Dentist
  • Coeur d'Alene, ID
  • NPI 1619197118
  NPD (past)

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

{
    "created_epoch": "1402617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537142400000",
    "number": "1629482070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5881 N PINEGROVE DR",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838158987",
            "telephone_number": "417-955-1966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2344 N MERRITT CREEK LOOP",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "83814",
            "telephone_number": "208-676-8500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "107 W Broadway St",
            "address_purpose": "LOCATION",
            "city": "El Dorado Springs",
            "state": "MO",
            "postal_code": "647441133",
            "country_code": "US",
            "telephone_number": "888-403-1071",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Osceola",
            "state": "MO",
            "postal_code": "647769547",
            "country_code": "US",
            "telephone_number": "888-403-1071",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3095 E Mullan Ave Ste 400",
            "address_purpose": "LOCATION",
            "city": "Post Falls",
            "state": "ID",
            "postal_code": "838540077",
            "country_code": "US",
            "telephone_number": "208-676-8500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DRYER",
        "first_name": "SHANNON",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-13",
        "last_updated": "2018-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2014018214",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D-4964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699114587",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Casey Deanne Drake, MSW
• Tarin Drapeau
• Bradley C Drury, M.D.
• Sydney Drury
• Bryan Rader Dryden, DDS
• Jeremy Jay Duanne, ARNP
• Eryn Ducote
• Edward Charles Dudding, NCC, LPC
• Mary Sandra Duff, ARNP
• Sara Duke, MD

• General Practice Dentistry in Coeur d'Alene, ID
• Providers in Coeur d'Alene, ID by specialty
• General Practice Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2018; 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.