Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1396842779 Individual Practitioner Male Practitioner

Shannon Widmier , DDSPA

Dentist - General Practice • Kimberly, ID

Professional Overview & Biography Verified Profile Summary

Shannon Widmier, DDSPA is a registered healthcare professional specializing in Dentist - General Practice in Kimberly, ID. Practice services are available at 702 CENTER STREET WEST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

702 Center Street West

Kimberly, ID 83341

Telephone 2084236444
Fax 2084236903
Associated Practice Facility / Clinic
🏢 Kent J Allen/ Shannon Widmier Facility NPI 1770769325

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Kimberly, ID

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 28.3 Yrs
Regional Practice Density
3 Specialists

Practicing in Kimberly, ID (781 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License ID D3342

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
Kent Allen , DDSPA

Dentist - General Practice

NPI 1407954191
NPI 1730575671

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 702 CENTER STREET WEST, KIMBERLY, ID 83341 (Tel: 2084236444)

📍
Updated Business Mailing Address July 08, 2007

Registered at PO BOX B, KIMBERLY, ID 833410010 (Tel: 2084236444)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as SHANNON WIDMIER, D.D. S. P.A.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #D3342 in ID)

🟢
Initial NPI Registration & Enumeration September 20, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1396842779
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 20, 2006
Last Update: July 08, 2007
Sole Proprietor: No

Mailing Address

Po Box B

Kimberly, ID 833410010

Phone: 2084236444

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.