AJ SHANNON DMD PLC NPI 1962790261

NPI Information

NPI: 1962790261
Provider Name: AJ SHANNON DMD PLC
Classification: Dentist - 1223P0221X
Entity Type: Organization

Specialization: Pediatric Dentistry

Address:
301 MAPLE AVE W
SUITE 200
VIENNA, VA
ZIP 22180
Phone: (703) 319-8370
Get Directions

AJ SHANNON DMD PLC is a pediatric dentistry dentist in Vienna, VA. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. AJ SHANNON DMD PLC NPI is 1962790261. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

301 MAPLE AVE W
SUITE 200
VIENNA, VA
ZIP 22180-301
Phone: (703) 319-8370
Fax: (703) 319-8371

The provider's authorized official is Andrew Jason Shannon .
The authorized official title is Dentist and has the following contact phone number (571) 230-8051.

The enumeration date for this NPI number is 7/20/2011 and was last updated on 7/20/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223P0221X	Dentist	Pediatric Dentistry	0401411773	VIRGINIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1982825097	MEDICAID	VIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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