Michael Timothy Shannon, D.M.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

17705 Issued in MA

Practice address

203 Turnpike Street
Suite G-2
North Andover, MA 01845

Phone

(978) 682-5255

Fax

(978) 682-0656

NPI assigned

Sep 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Oral Surgery

Education

Other, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shannon and Hunter PCGroup PAC ID 8729164330, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Shannon & Hunter PC

  • Oral and Maxillofacial Surgery (Dentist)
  • North Andovor, MA
  • NPI 1295841757
  Medicare reassignment Care Compare group Authorized official

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649378449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 TURNPIKE STREET",
            "address_2": "SUITE G-2",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "01845",
            "telephone_number": "978-682-5255",
            "fax_number": "978-682-0656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 TURNPIKE STREET",
            "address_2": "SUITE G-2",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "01845",
            "telephone_number": "978-682-5255",
            "fax_number": "978-682-0656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "MICHAEL",
        "middle_name": "TIMOTHY",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MA",
            "license": "17705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Serenity Health Associates, Inc
• Aldo Paul Sferra, CNP
• Dipti V Shah, RPT
• Megha Shah
• Sajjad Shaikh, RPH
• Olivia Marie Shapiro
• Joseph Michael Shaughnessy
• Rebecca Shaw
• Shea Sports Chiropractic, LLC
• Danielle Sheehan

• Oral and Maxillofacial Surgery (Dentist) in North Andover, MA
• Providers in North Andover, MA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Massachusetts

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.