SHONNA WHEELER (NPI# 1134696156) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134696156 |
| Entity Type | Individual |
| Full Name | SHONNA WHEELER |
| Practice Address |
100 Slocum Drive King Cove AK 99612 |
| Mailing Address |
3380 C St Ste 100 Anchorage AK 99503-3949 |
| Practice Telephone | 9074972311 |
| Practice Fax Number | 9074972310 |
| Mailing Telephone | 9072771440 |
| Mailing Fax Number | 9072771436 |
| Enumeration Date | 2018-10-29 |
| Last Update Date | 2018-10-29 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 125J00000X | Dental Therapist | 18150DHAT | AK | Dental Providers |
| Street Address |
100 SLOCUM DRIVE |
| City | KING COVE |
| State | AK |
| Zip Code | 99612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619064417 | Paul Skinner | Physician Assistant | 100 Slocum Drive, King Cove, AK 99612-0000 | 2006-10-05 |
| 1649832049 | Cosette Marie Nielsen | Student in an Organized Health Care Education/Training Program | 100 Slocum Drive, King Cove, AK 99612-9961 | 2019-07-05 |
| 1972082592 | Brenda Wilson | Counselor | 100 Slocum Drive, King Cove, AK 99612-0009 | 2018-08-14 |
| 1689048118 | Susan Starr Higley-bailey | Registered Nurse | 100 Slocum Drive, King Cove, AK 99612-0009 | 2015-11-20 |
| 1598189714 | Vincent Perino | Physician Assistant | 100 Slocum Drive, King Cove Clinic, King Cove, AK 99612-0100 | 2014-02-07 |
| 1275875742 | Erik J Linduska | Dental Therapist | 100 Slocum Drive, King Cove, AK 99612 | 2013-03-22 |
| 1376839233 | Riza Zoe Bendixen | Community Health Worker | 100 Slocum Drive, King Cove, AK 99612 | 2011-06-20 |
| 1154636207 | Summer Ann Mack | Community Health Worker | 100 Slocum Drive, King Cove, AK 99612 | 2010-08-13 |
| 1235444886 | Anthony R Brown | Community Health Worker | 100 Slocum Drive, King Cove, AK 99612 | 2010-08-06 |
| 1417192410 | Joanna R. Fountain | Specialist | 100 Slocum Drive, King Cove, AK 99612 | 2008-12-05 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285825596 | Sevilla Ingersoll Love | Social Worker | 100 Slocum Dr., King Cove, AK 99612 | 2007-08-05 |
| 1144252529 | Michael E Costa | Dentist | 100 Slocum Dr, King Cove, AK 99612 | 2006-07-07 |
| 1912317207 | Christine Prokop | Counselor | 9 Main Street, King Cove, AK 99612 | 2014-05-07 |
| 1861676843 | Jenny Louise Kenezuroff | Specialist | 101 Slocum Drive, King Cove, AK 99612-0009 | 2007-12-26 |
| 1841474848 | Priscilla Jean Miller | Specialist | 101 Slocum Drive, King Cove, AK 99612-0009 | 2007-12-27 |
| 1821457227 | King Cove Fire & Rescue | Ambulance | 289 Rams Creek Drive, King Cove, AK 99612-0289 | 2016-02-15 |
| Taxonomy Code | 125J00000X |
| Grouping | Dental Providers |
| Classification | Dental Therapist |
| A Dental Therapist is an individual who has completed an accredited or non-accredited dental therapy program and who has been authorized by the relevant state board or a tribal entity to provide services within the scope of their practice under the supervision of a dentist. Functions that may be delegated to the dental therapist vary based on the needs of the dentist, the educational preparation of the dental therapist and state dental practice acts and regulations. |
| Notes: Source: Summarized from Minnesota Statute 150A.105. [7/1/2012: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275875742 | Erik J Linduska | Dental Therapist | 100 Slocum Drive, King Cove, AK 99612 | 2013-03-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083251607 | Tamija Katrice Woods | Dental Therapist | 4519 E 4th Ave, Anchorage, AK 99508-2216 | 2019-12-02 |
| 1538541693 | Amanda Miles | Dental Therapist | 3449 E. Rezanof Drive, Dental Department, Kodiak, AK 99615-3449 | 2015-06-25 |
| 1205236692 | Kimberly Baldwin | Dental Therapist | 436 5th Ave Ted Stevens Way, Kotzebue, AK 99752 | 2014-09-04 |
| 1205265345 | Cora Roberts | Dental Therapist | 201 3rd Avenue, Suite 115, Seward, AK 99664 | 2013-11-08 |
| 1326654245 | Kathrine G.d.a Levi | Dental Therapist | 700 Chief Eddie Hoffman Hwy, Bethel, AK 99559 | 2020-09-16 |
| 1790320513 | Ruby Okitkun | Dental Therapist | 700 Chief Eddie Hoffman Hwy, Bethel, AK 99559 | 2019-11-15 |
| 1336783075 | Allison Kristi Wasuli | Dental Therapist | 733 2nd Avenue, Kotzebue, AK 99752 | 2019-11-06 |
| 1922579143 | Janette Carmen Ulak | Dental Therapist | 49 Airport Rd, Hooper Bay Clinic, Hooper Bay, AK 99604 | 2018-12-16 |
| 1609345677 | Samantha Sparks | Dental Therapist | 222 Tongass Dr, Sitka, AK 99835-9416 | 2018-11-19 |
| 1881160570 | Leandra Beech | Dental Therapist | 1001 S Knik Goose Bay Rd, Wasilla, AK 99654-8083 | 2018-10-19 |
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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.