FENRIS SCUDDER (NPI# 1053501668) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053501668 |
| Entity Type | Individual |
| Full Name | FENRIS SCUDDER |
| Credential | D.D.S |
| Practice Address |
3100 Se Old Olympic Hwy Shelton WA 98584-7731 |
| Practice Telephone | 3604271784 |
| Practice Fax Number | 3604271818 |
| Mailing Telephone | 3604271784 |
| Mailing Fax Number | 3604271818 |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2007-07-30 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | DE00007430 | WA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | DSHS PROVIDER NUMBER | 5027990 | 01 |
| Street Address |
3100 SE OLD OLYMPIC HWY |
| City | SHELTON |
| State | WA |
| Zip Code | 98584-7731 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215000666 | Steven R Peters | Denturist | 3100 Se Old Olympic Hwy, Shelton, WA 98584 | 2006-11-15 |
| 1063969533 | Brittany Anne Peschek | Denturist | 3100 Se Old Olympic Hwy, Shelton, WA 98584 | 2016-09-01 |
| 1023235397 | Caden Ngo | Dentist | 3100 Se Old Olympic Hwy, Shelton, WA 98584-7731 | 2007-04-19 |
| 1992922272 | Shi Yan | Denturist | 3100 Se Old Olympic Hwy, Shelton, WA 98584-7731 | 2007-04-19 |
| 1043379480 | Kamilche Dental Center | Denturist | 3100 Se Old Olympic Hwy, Shelton, WA 98584-7731 | 2006-12-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023627478 | Ashley Maria Elena Armstrong | Counselor | 307 W Cota St Shelton, Shelton, WA 98584 | 2020-07-30 |
| 1962011015 | Perry Philemon Little IIi | Dentist | 503 N 4th St, Shelton, WA 98584 | 2020-07-24 |
| 1588215271 | Rebecca Lynn Adams | Counselor | 601 West Franklin St, Shelton, WA 98584 | 2019-09-24 |
| 1366939670 | Robbie Chandler | Social Worker | 807 West Pine, Shelton, WA 98584 | 2018-04-23 |
| 1831603075 | Fir Lane Health-shelton,llc | Skilled Nursing Facility | 2430 North 13th St, Shelton, WA 98584 | 2017-11-27 |
| 1306361738 | Christine Lee Woods | Counselor | 58150 E. 66th Road, Miami, OK 98584 | 2017-08-07 |
| 1174063051 | Claudette V. Selkridge | Counselor | 1620 N. Olympic Hwy, Shelton, WA 98584 | 2017-02-27 |
| 1003278755 | Edward Charles Herman | Social Worker | 50 Se Bluff Loop Rd., Shelton, WA 98584 | 2016-03-22 |
| 1023497310 | Darren Cuevas | Family Medicine | 939 Mountain View Dr Ste 100, Shelton, WA 98584 | 2015-05-20 |
| 1639572977 | Thomas Vincent Phung Duffy | Dentist | 717 W. Railroad Ave., Shelton, WA 98584 | 2014-10-01 |
| Find all providers in zip 98584 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639572977 | Thomas Vincent Phung Duffy | Dentist | 717 W. Railroad Ave., Shelton, WA 98584 | 2014-10-01 |
| 1528398179 | Allan Rex Davis | Dentist | 531 E Dana Dr, Shelton, WA 98584-7599 | 2010-01-04 |
| 1265686463 | Kyle Houston Hackney | Dentist | 1051 Se State Route 3, Shelton, WA 98584-7117 | 2008-11-14 |
| 1437207081 | John Shay Schreiber | Dentist | 639 Holly Ct, Shelton, WA 98584-1327 | 2007-01-08 |
| 1760530315 | Smile Connecticut, Pllc | Dentist | 4 Research Dr, Suite 402, Shelton, CT 06484-6212 | 2007-01-08 |
| 1255490496 | Steven Herschel Bowers | Dentist | 717 W Railroad Ave, Shelton, WA 98584 | 2006-12-06 |
| 1164500138 | Glenn A Ganz | Dentist | 76 Howe Ave, Shelton, CT 06484 | 2006-11-01 |
| 1972014744 | Shelton Dental Group LLC | Dentist | 169 Center St, Shelton, CT 06484-3241 | 2017-10-19 |
| 1649640285 | Priscila Guzman | Dentist | 185 Canal St, Apt #3102, Shelton, CT 06484-8121 | 2015-09-25 |
| 1619374881 | Northeast Dental of Connecticut,pc | Dentist | 534 Shelton Ave, Shelton, CT 06484-2804 | 2014-12-03 |
| Find all providers in SHELTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.