DR. SHAWN MICHAEL WIDICK (NPI# 1770610297) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770610297 |
| Entity Type | Individual |
| Full Name | DR. SHAWN MICHAEL WIDICK |
| Credential | D.D.S. |
| Practice Address |
704 Healdsburg Ave Suite A Healdsburg CA 95448-3651 |
| Practice Telephone | 7074336907 |
| Practice Fax Number | 7074331302 |
| Mailing Telephone | 7074336907 |
| Mailing Fax Number | 7074331302 |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2012-12-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
43098 | CA | Dental Providers |
| Street Address |
704 HEALDSBURG AVE SUITE A |
| City | HEALDSBURG |
| State | CA |
| Zip Code | 95448-3651 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457697542 | Shawn Widick, D.d.s. Inc. | Dentist | 704 Healdsburg Ave, Suite A, Healdsburg, CA 95448-3651 | 2012-12-18 |
| 1003938408 | George Peter Schulze | Dentist | 704 Healdsburg Ave, Suite A, Healdsburg, CA 95448-3651 | 2007-04-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891342002 | Linda Lazzar Friend | Marriage & Family Therapist | 2800 Hilltop Rd., Healdsburg, CA 95448 | 2019-08-22 |
| 1184124513 | Pacifica Sl Grove Street Lp | Alzheimer Center (Dementia Center) | 725 Grove Street, Healdsburg, CA 95448 | 2018-02-12 |
| 1073049284 | Jennifer Gnass | Counselor | 536 March Ave, Healdsburg, CA 95448 | 2017-05-08 |
| 1538523105 | Zormeier Cosmetic Surgery & Longevity Center | Plastic Surgery | 431 East Street Ste B, Healdsburg, CA 95448 | 2016-04-11 |
| 1619180700 | Sharron Levinger Rudell | Marriage & Family Therapist | 459 Hudson St, Healdsburg, CA 95448 | 2007-05-07 |
| 1932224490 | Stanley Winstonj Jacobs | Specialist | 145 Foss Creek Cir., Healdsburg, CA 95448 | 2007-03-20 |
| 1821126491 | Eric Culbertson | Surgery | 145 Foss Creek Cir, Healdsburg, CA 95448 | 2007-03-02 |
| 1265508790 | Stanley D Davis | Psychiatry & Neurology | 451 A March Ave, Healdsburg, CA 95448 | 2006-11-27 |
| 1306910559 | Christine Naber | Clinical Neuropsychologist | 455 March Ave Ste A, Healdsburg, CA 95448 | 2006-11-20 |
| 1700978947 | Marc Alexander | Dentist | 125 Grant Street, Healdsburg, CA 95448 | 2006-09-28 |
| Find all providers in zip 95448 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710292495 | Raafia Mazhar | Dentist | 1260 Healdsburg Ave Ste 101, Healdsburg, CA 95448-3409 | 2010-08-18 |
| 1972759405 | Amy Margaret Munselle | Dentist | 125 Grant St, Healdsburg, CA 95448-3824 | 2008-08-15 |
| 1639382377 | Ashby L. Chadburn | Dentist | 217 Matheson St, Healdsburg, CA 95448-4109 | 2007-05-08 |
| 1487870663 | Robert S. Leach | Dentist | 1260 Healdsburg Ave, Suite 101, Healdsburg, CA 95448-3407 | 2007-04-17 |
| 1669565115 | Stephen Conrad Jarvis | Dentist | 606 Center St, Healdsburg, CA 95448-3603 | 2006-10-02 |
| 1700978947 | Marc Alexander | Dentist | 125 Grant Street, Healdsburg, CA 95448 | 2006-09-28 |
| 1558370841 | Michael W. Neal | Dentist | 441 March Ave Ste B, Healdsburg, CA 95448-3363 | 2006-08-05 |
| 1679735146 | Dana Diane Yee | Dentist | 1381 University St, Healdsburg, CA 95448-3314 | 2008-06-26 |
| 1205015716 | Martha M Schwartz | Dentist | 1381 University St, Healdsburg, CA 95448 | 2007-10-31 |
| 1003947292 | Michael Brunner | Dentist | 606 Center St, Healdsburg, CA 95448-3603 | 2007-03-08 |
| Find all providers in HEALDSBURG | ||||
| City | HEALDSBURG |
| Zip Code | 95448 |
Please comment or provide details below to improve the information on DR. SHAWN MICHAEL WIDICK.
| 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.