Healthcare Provider Details

I. General information

NPI: 1801744396
Provider Name (Legal Business Name): JILL SHANNON NAVARRO RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2650 E SHOW LOW LAKE RD STE 1
SHOW LOW AZ
85901-7955
US

IV. Provider business mailing address

PO BOX 1231
TUCSON AZ
85702-1231
US

V. Phone/Fax

Practice location:
  • Phone: 928-537-4300
  • Fax: 928-532-6901
Mailing address:
  • Phone: 520-670-3909
  • Fax: 520-309-2560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberH05016
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: