Shaun Patrick Gardner, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5603 Issued in AZ

Practice address

2045 S Vineyard Ste 150
Mesa, AZ 85210-6892

Phone

(480) 345-7668

Fax

(480) 413-1408

NPI assigned

Jan 29, 2007

Last updated

Nov 4, 2021By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635984000000",
    "number": "1902942923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2045 S VINEYARD STE 150",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852106892",
            "telephone_number": "480-345-7668",
            "fax_number": "480-413-1408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2045 S VINEYARD STE 150",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852106892",
            "telephone_number": "480-345-7668",
            "fax_number": "480-413-1408"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3970 E Riggs Rd Ste 3",
            "address_purpose": "LOCATION",
            "city": "Chandler",
            "state": "AZ",
            "postal_code": "852495412",
            "country_code": "US",
            "telephone_number": "480-895-4040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "SHAUN",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2021-11-04",
        "certification_date": "2021-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "5603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey W Gardner, PT, DPT
• Kisha M. Gardner, SLPA
• Mara Gardner
• Monce Gardner
• Quinton Wayne Gardner, DMD
• Swandelyn Gardner, LPC
• Terry Franklin Gardner, DDS
• Ameesh K Garg, MD
• Ashok Garg, M.D.
• Yukti Garg

• General Practice Dentistry in Mesa, AZ
• Providers in Mesa, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2021; 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.