Individual provider Active NPI

Adwar Shamuna, DMD

  • Dentist
  • Hayward, WI
National Provider Identifier
1699465120
Registry record updated Jul 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6002246-15 Issued in WI
Practice address
15954 Rivers Edge Dr
Hayward, WI 54843-7800
Phone
(715) 634-2541
NPI assigned
May 9, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 6002246-15 WI Primary

Addresses

Primary practice location

15954 Rivers Edge Dr
Hayward, WI 54843-7800

Mailing address

9350 Harritt Rd
Lakeside, CA 92040-3503
Phone (619) 792-8042

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

NPI Registry JSON

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

{
    "created_epoch": "1683590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783468800000",
    "number": "1699465120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9350 HARRITT RD",
            "city": "LAKESIDE",
            "state": "CA",
            "postal_code": "920403503",
            "telephone_number": "619-792-8042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15954 RIVERS EDGE DR",
            "city": "HAYWARD",
            "state": "WI",
            "postal_code": "548437800",
            "telephone_number": "715-634-2541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAMUNA",
        "first_name": "ADWAR",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-09",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "WI",
            "license": "6002246-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hayward, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2026; 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.