Shawn T McCullough DDS, PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SHAWN T MCCULLOUGH DDS, PLLC

Doing business as

Sun Dental

Practice address

6041 Main St Ste C
North Branch, MN 55056-6589

Phone

(651) 674-4811

NPI assigned

Jun 19, 2019

Organization subpart

No

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

Authorized official

Name

Shawn Timothy McCullough, DDSNPI 1023171196

Title

Owner

Phone

(651) 674-4811

Specialties & licenses 1

Addresses

Other names 1

• Sun Dental Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shawn Timothy McCullough, DDS

  • Dentist
  • North Branch, MN
  • NPI 1023171196
  NPD Authorized official

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

{
    "created_epoch": "1560902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560902400000",
    "number": "1841850062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40",
            "address_2": "6041 MAIN STREET",
            "city": "NORTH BRANCH",
            "state": "MN",
            "postal_code": "55056",
            "telephone_number": "651-674-4811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6041 MAIN ST STE C",
            "city": "NORTH BRANCH",
            "state": "MN",
            "postal_code": "550566589",
            "telephone_number": "651-674-4811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAWN T MCCULLOUGH DDS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-19",
        "last_updated": "2019-06-19",
        "status": "A",
        "authorized_official_last_name": "MCCULLOUGH",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_middle_name": "TIMOTHY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "651-674-4811",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sun Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Richard R. Nyman, D.D.S., P.a. (North Branch Dental)
• Kristen Elise Ross, PHARMD
• Sage Spine Pain and Nerve Center
• Amanda Sawyer, L.AC.
• Priya Devi Shaffer, DDS
• Shift Solutions
• Shopko Stores Operating Co LLC (ShopKo Optical 179)
• Shopko Stores Operating Co LLC (ShopKo Pharmacy 179)
• Erica Sierra
• Amanda Marie Simonson, LADC

• Dental Clinic/Center in North Branch, MN
• Providers in North Branch, MN by specialty
• Dental Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2019; 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.