Shannon Wilson DDS PS

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SHANNON WILSON DDS PS

Practice address

11730 15TH Ave NE
Seattle, WA 98125-5026

Phone

(206) 920-5430

NPI assigned

Dec 11, 2024

Last updated

Dec 11, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Shannon Wilson, DDSNPI 1255064952

Title

Owner

Phone

(206) 920-5430

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shannon Murray Wilson, DDS

  • General Practice Dentistry
  • Seattle, WA
  • NPI 1255064952
  NPD Authorized official

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

{
    "created_epoch": "1733875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733875200000",
    "number": "1710794979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18529 LINDEN AVE N",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981333926",
            "telephone_number": "206-920-5430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11730 15TH AVE NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981255026",
            "telephone_number": "206-920-5430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANNON WILSON DDS PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-11",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-920-5430",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Veena Shankaran, MD
• Stuart J Shankland
• Ann Marie Shankle, MSW, LICSW
• Anna Elizabeth Shanks, ARNP
• Shannon Solie Therapy Incorported
• Douglas Shannon, PA-C
• Jordan Patrick Shannon, PHD, LMHCA, NCC
• Margaret Shannon, LMHC
• Michael Brendan Shannon, M.D.
• Michael Caroll Shannon, MD

• Dental Clinic/Center in Seattle, WA
• Providers in Seattle, WA by specialty
• Dental Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2024; 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.