Provider Demographics
NPI:1407293541
Name:MONAHAN, WILLIAM SHAWN (DMD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:SHAWN
Last Name:MONAHAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20713 E OCOTILLO RD STE 102
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-6117
Mailing Address - Country:US
Mailing Address - Phone:480-888-8123
Mailing Address - Fax:
Practice Address - Street 1:20713 E OCOTILLO RD STE 102
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85142-6117
Practice Address - Country:US
Practice Address - Phone:480-888-8123
Practice Address - Fax:480-888-8374
Is Sole Proprietor?:No
Enumeration Date:2013-05-30
Last Update Date:2021-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD008339122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist