Provider Demographics
NPI:1407948656
Name:MCCARTHY, SHANNON H (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHANNON
Middle Name:H
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5853 TRANSIT RD
Mailing Address - Street 2:
Mailing Address - City:EAST AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14051-1885
Mailing Address - Country:US
Mailing Address - Phone:716-689-4111
Mailing Address - Fax:716-929-0443
Practice Address - Street 1:5853 TRANSIT RD
Practice Address - Street 2:
Practice Address - City:EAST AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14051-1885
Practice Address - Country:US
Practice Address - Phone:716-689-4111
Practice Address - Fax:716-929-0443
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0471651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice