Kirk M Shillinger, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE00008730 Issued in WA

Practice address

19111 SE 34TH St
Suite 104
Vancouver, WA 98683-1449

Phone

(360) 823-0427

Fax

(360) 823-0428

NPI assigned

Sep 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• J Winger, DDS, PLLC

  • General Practice Dentistry
  • Vancouver, WA
  • NPI 1134093065
  NPD (past)
• Jacob D Groom DMD PLLC

  • General Practice Dentistry
  • Vancouver, WA
  • NPI 1699560300
  NPD (past)
• Wendel Family Dental Centre PS

  • General Practice Dentistry
  • Vancouver, WA
  • NPI 1295844900
  NPD (past)

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871697490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7012 NE 40TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986613052",
            "telephone_number": "360-254-5254",
            "fax_number": "360-944-3835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19111 SE 34TH ST",
            "address_2": "SUITE 104",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986831449",
            "telephone_number": "360-823-0427",
            "fax_number": "360-823-0428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHILLINGER",
        "first_name": "KIRK",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00008730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "0158868",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA ST CRIME VICTIMS",
            "identifier": "8932839",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5034970",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Timofey Shevchenko, RN
• Junzi Shi, MD
• Amber Dawn Shields, LMT
• Lindsey Shields
• Shillinger DDS PS
• Ryota Shimada, MD, PHD
• Iris Shimizu
• Rebecca Shine
• Christine Nicole Shinn, LMT
• Shirley Shen PHD LLC

• General Practice Dentistry in Vancouver, WA
• Providers in Vancouver, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.