Caitlin Suzanne Shannon, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12013403A Issued in IN

Practice address

2519 E Main St Ste 102
Richmond, IN 47374-5869

Phone

(765) 962-1519

NPI assigned

Apr 16, 2020

Last updated

Jun 26, 2020By 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 names 1

• Caitlin Suzanne Whitaker Former name

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.

• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)

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

{
    "created_epoch": "1586995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593129600000",
    "number": "1699394916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 W COUNTY ROAD 100 S",
            "city": "NEW CASTLE",
            "state": "IN",
            "postal_code": "473622578",
            "telephone_number": "317-617-8373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2519 E MAIN ST STE 102",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473745869",
            "telephone_number": "765-962-1519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "CAITLIN",
        "middle_name": "SUZANNE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-16",
        "last_updated": "2020-06-26",
        "certification_date": "2020-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12013403A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAITLIN",
            "last_name": "WHITAKER",
            "middle_name": "SUZANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Senior Opportunity Services
• Senior Suites at the Leland (The Leland Legacy)
• Chanlar Seymour, OTR
• Wendi Shaffmaster, NP-C
• Tanay Shah, M.D.
• Vikram Sharma
• Andrew Blair Shaw, MD
• Brooklyn Shaw
• Debra Kay Shaw, ANP-BC
• Amid Shayesteh, D.O.

• General Practice Dentistry in Richmond, IN
• Providers in Richmond, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2020; 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.