TIMOTHY PATRICK SHANNON (NPI# 1770641128) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770641128 |
| Entity Type | Individual |
| Full Name | TIMOTHY PATRICK SHANNON |
| Credential | D.M.D. |
| Practice Address |
4450 Se Johnson Creek Blvd Milwaukie OR 97222-9217 |
| Mailing Address |
7524 Se 31st Ave Portland OR 97202-8533 |
| Practice Telephone | 5036547773 |
| Practice Fax Number | 5036547774 |
| Mailing Telephone | 5037711106 |
| Mailing Fax Number | 5036547774 |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
D6975 | OR | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730614579 | Timothy Patrick Shannon | Technician, Pathology | 6748 Mary Ave Nw, #104, Seattle, WA 98117-5360 | 2017-05-01 |
| 1952314817 | Timothy Michael Shannon | Dentist | 2214 W Boyd St, Norman, OK 73069-4836 | 2006-08-14 |
| 1457314858 | Timothy W Shannon | Optometrist | 1234 7th St, Suite 2, Santa Monica, CA 90401-1614 | 2006-04-08 |
| 1801832597 | Timothy M. Shannon | Specialist | 4801 S Congress Ave, Suite 301, Lake Worth, FL 33461-4746 | 2006-06-21 |
| 1811968589 | Timothy J Shannon | Orthopaedic Surgery | 410 University Pkwy, Suite 1000, Aiken, SC 29801 | 2006-01-30 |
| Street Address |
4450 SE JOHNSON CREEK BLVD |
| City | MILWAUKIE |
| State | OR |
| Zip Code | 97222-9217 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982706677 | Timothy P. Shannon D.m.d., P.C. | Dentist | 4450 Se Johnson Creek Blvd, Milwaukie, OR 97222-9217 | 2006-09-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831731397 | Madalyn Kelly Yowell | Technician | 7809 Southeast Southgate Street, Milwaukee, OR 97222 | 2019-10-16 |
| 1336617448 | Nadia Yang | Social Worker | 2115 Se Adams St, Milwaukie, OR 97222 | 2018-11-06 |
| 1851892368 | Arrow Dental LLC | Dentist | 10505 Se 17th Avenue, Milwaukie, OR 97222 | 2018-02-21 |
| 1851814016 | Cathy Maria Andrew | Acupuncturist | 11022 Se Stanley Ave, Milwaukie, OR 97222 | 2017-07-19 |
| 1972025369 | Sarah Elizabeth Giles | Peer Specialist | 11097 Se 21st Ave., Milwaukie, OR 97222 | 2017-07-07 |
| 1366976292 | Brittany Reubendale | Physical Therapist | 12705 See River Rd, Portland, OR 97222 | 2017-04-18 |
| 1669916383 | Margie Hertz | Registered Nurse | 6406 Se Cedarcrest Drive, Milwaukie, OR 97222 | 2016-12-14 |
| 1952858094 | Alexis Escobar | Speech-Language Pathologist | 4560 Se International Way, Ste 100, Milwaukie, OR 97222 | 2016-09-07 |
| 1205295466 | Beth Ann Mills | Acupuncturist | 2025 Se Jefferson St Ste 106, Milwaukie, OR 97222 | 2016-02-16 |
| 1558744086 | Kyle Eugene Coan | Specialist | 3306 Se Wister St, Milwaukie, OR 97222 | 2015-07-01 |
| Find all providers in zip 97222 | ||||
| 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 |
|---|---|---|---|---|
| 1558996728 | Jeffrey S Casebier Dmd LLC | Dentist | 2636 Se Harrison St Ste B, Milwaukie, OR 97222-7587 | 2020-03-09 |
| 1992038277 | Michael S. Harper | Dentist | 3300 Se Dwyer Dr Ste 302, Milwaukie, OR 97222-6548 | 2009-09-17 |
| 1851455471 | Jo Ellen Winston, Dmd | Dentist | 3016 Se Courtney Rd, Milwaukie, OR 97222-7104 | 2006-12-20 |
| 1346301603 | Matthew Hill | Dentist | 17186 Se Mcloughlin Blvd, Milwaukie, OR 97267 | 2006-12-12 |
| 1073671640 | Donald J Nimz | Dentist | 16230 Se Mcloughlin Blvd, Milwaukie, OR 97267-4657 | 2006-12-05 |
| 1699833772 | Alireza Farid Bolouri | Dentist | 11103 Se Main St, Suite B, Milwaukie, OR 97222 | 2006-12-04 |
| 1003989435 | Rodney C. Lippert | Dentist | 7000 Se Thiessen Rd, Milwaukie, OR 97267-2042 | 2006-11-15 |
| 1811087257 | John Wayne Leroy | Dentist | 4506 Se King Rd, Milwaukie, OR 97222 | 2006-10-14 |
| 1467542423 | Charles A. Miller IIi | Dentist | 9701 Se 43rd Ave, Milwaukie, OR 97222-5768 | 2006-10-13 |
| 1982706677 | Timothy P. Shannon D.m.d., P.C. | Dentist | 4450 Se Johnson Creek Blvd, Milwaukie, OR 97222-9217 | 2006-09-02 |
| Find all providers in MILWAUKIE | ||||
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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.