Provider Demographics
NPI:1134279748
Name:ESPINOLA, SHANNON RODRIGUES (DMD)
Entity Type:Individual
Prefix:DR
First Name:SHANNON
Middle Name:RODRIGUES
Last Name:ESPINOLA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1395 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02723-1718
Mailing Address - Country:US
Mailing Address - Phone:508-672-8984
Mailing Address - Fax:508-672-4239
Practice Address - Street 1:1395 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02723-1718
Practice Address - Country:US
Practice Address - Phone:508-672-8984
Practice Address - Fax:508-672-4239
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA21670122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist