Jonathan R Shaw DDS PS

Primary specialty

DentistTaxonomy code 122300000X

License

4798 Issued in WA

Legal business name

JONATHAN R SHAW DDS PS

Practice address

214 West Birch
Colville, WA 99114

Phone

(509) 684-6138

Fax

(509) 684-0884

NPI assigned

Aug 24, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jonathan R Shaw, DDS

Title

President of Corp

Phone

(509) 684-6138

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

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

• Karl John Hunt, DDS

  • General Practice Dentistry
  • Colville, WA
  • NPI 1962586578
  NPD (past)

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1982711818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 WEST BIRCH",
            "city": "COLVILLE",
            "state": "WA",
            "postal_code": "99114",
            "telephone_number": "509-684-6138",
            "fax_number": "509-684-0884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 WEST BIRCH",
            "city": "COLVILLE",
            "state": "WA",
            "postal_code": "99114",
            "telephone_number": "509-684-6138",
            "fax_number": "509-684-0884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JONATHAN R SHAW DDS PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT OF CORP",
        "authorized_official_telephone_number": "509-684-6138",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "WA",
            "license": "4798",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5503107",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA INS",
            "identifier": "784537",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jenna B Johnson, MSW
• Laura S Johnson, CDPT
• Sasha Johnson, LMT
• Kathy M Johnstun
• Regina L Jolley, RC
• Cheyenne J Jones
• Danielle M Jones
• Gary Wayne Jones
• Sheila J Jones
• Teresa A. Jones, RD

• Dentist in Colville, WA
• Providers in Colville, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.