Shawn Kevin Otteson, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

D009292 Issued in AZ

Practice address

4501 N 7TH St
Phoenix, AZ 85014-3804

Phone

(602) 845-5730

NPI assigned

Jul 29, 2015

Last updated

Jul 29, 2015By 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)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Phoenix Central Dental Partners LLC

  dba Risas Dental and Braces

  • General Practice Dentistry
  • Phoenix, AZ
  • NPI 1053176362
  NPD (past)

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

{
    "created_epoch": "1438128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438128000000",
    "number": "1952786170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4501 N 7TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850143804",
            "telephone_number": "602-845-5730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 N 7TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850143804",
            "telephone_number": "602-845-5730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTESON",
        "first_name": "SHAWN",
        "middle_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-29",
        "last_updated": "2015-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D009292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jane Frances Otstot, L.P.C.
• Christopher Leonard Ott, PHARM.D.
• David M Ott, M.D.
• Hilary Ottaviano
• Beth Otterstein
• Otto Bock Orthopedic Services LLC
• Otto Bock Patient Care, LLC
• Mario Otto, M.D., PH.D.
• Phyllis Otu, LSAT
• Jason Heng Ou, PA-C

• Dentist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Dentist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2015; 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.