Shannon J Daughtry DDS Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

42141 Issued in CA

Legal business name

SHANNON J DAUGHTRY DDS INC

Practice address

250 Main St
Brawley, CA 92227-2351

Phone

(760) 344-3262

Fax

(760) 344-1369

NPI assigned

Oct 11, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Lea Daughtry

Title

Business Manager

Phone

(760) 344-3262

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1192060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258070400000",
    "number": "1740478064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 MAIN ST",
            "city": "BRAWLEY",
            "state": "CA",
            "postal_code": "922272351",
            "telephone_number": "760-344-3262",
            "fax_number": "760-344-1369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 MAIN ST",
            "city": "BRAWLEY",
            "state": "CA",
            "postal_code": "922272351",
            "telephone_number": "760-344-3262",
            "fax_number": "760-344-1369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANNON J DAUGHTRY DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-11",
        "last_updated": "2009-11-13",
        "status": "A",
        "authorized_official_last_name": "DAUGHTRY",
        "authorized_official_first_name": "LEA",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "760-344-3262",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "42141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• SC Surgery Network, Inc.
• Theodore Louis Schlater III, M.D.
• Jacob Matthew Scholl, PA
• Natalie Marie Serra, CRNA
• Melinda Serrano, CRNA
• Shelly Sharma, PHARMD
• Brian Shue, MD
• Kristina Silva
• Mark Simpson, PA-C
• Liliana Siordia-Ramirez, LMFT

• General Practice Dentistry in Brawley, CA
• Providers in Brawley, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2009; 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.