Healthcare Provider Details

I. General information

NPI: 1467554386
Provider Name (Legal Business Name): SHANNON R STEVENS-MCLAIN D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2006
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

447 OAKWOOD AVE
WILLIAMSTOWN WV
26187-1346
US

IV. Provider business mailing address

447 OAKWOOD AVE
WILLIAMSTOWN WV
26187-1346
US

V. Phone/Fax

Practice location:
  • Phone: 304-375-7742
  • Fax: 304-375-9161
Mailing address:
  • Phone: 304-375-7742
  • Fax: 304-375-9161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number3695
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: