MEDICARE: DR. LELAND WALKER SHENFIELD DDS, MSD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0221X	Pediatric Dentistry	DE00008850	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558476770
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LELAND WALKER SHENFIELD DDS, MSD

Provider Business Mailing Address
First Line	:	16030 BOTHELL EVERETT HWY
Second Line	:	SUITE 250
City	:	MILL CREEK
State	:	WA
Zip	:	98012-1741
Country	:	US
Telephone Number	:	425-338-9773
Fax Number	:	425-338-9743

Provider Business Practice Location Address
First Line	:	16030 BOTHELL EVERETT HWY
Second Line	:	SUITE 250
City	:	MILL CREEK
State	:	WA
Zip	:	98012-1741
Country	:	US
Telephone Number	:	425-338-9773
Fax Number	:	425-338-9743

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/20/2006
Last Update Date	:	03/07/2023

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