Active NPI
Shannon Wilson, RDH
- Dental Hygienist
- Broomfield, CO
National Provider Identifier
1639080088
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- DH.000906327
- Practice address
- 925 Main St Ste C
Broomfield, CO 80020-1976 - Phone
- (303) 469-3600
- NPI assigned
- Sep 15, 2026
- 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 | DH.000906327 | CO | Primary |
Addresses
Primary practice location
925 Main St Ste C
Broomfield, CO 80020-1976
Mailing address
3909 W 99TH PL
Westminster, CO 80031-2645
Phone (307) 690-8725
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1789430400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1789430400000",
"number": "1639080088",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3909 W 99TH PL",
"city": "WESTMINSTER",
"state": "CO",
"postal_code": "800312645",
"telephone_number": "307-690-8725"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "925 MAIN ST STE C",
"city": "BROOMFIELD",
"state": "CO",
"postal_code": "800201976",
"telephone_number": "303-469-3600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "SHANNON",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-09-15",
"last_updated": "2026-09-15",
"certification_date": "2026-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "CO",
"license": "DH.000906327",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Broomfield, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.