Provider Demographics
NPI:1518024587
Name:WRIGHT, SHAUN TOM (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHAUN
Middle Name:TOM
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:99 S MARKET ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-2200
Mailing Address - Country:US
Mailing Address - Phone:808-244-5495
Mailing Address - Fax:808-244-5525
Practice Address - Street 1:99 S MARKET ST
Practice Address - Street 2:SUITE 102
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-2200
Practice Address - Country:US
Practice Address - Phone:808-244-5495
Practice Address - Fax:808-244-5525
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2009-03-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HIDT 20381223P0221X
CA478261223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA47826OtherSTATE DENTAL LICENSE NUMB
HIDT 2038OtherSTATE DENTAL LICENSE NUMB