Provider Demographics
NPI:1558251058
Name:FOLEY, SHANNON (DDS)
Entity type:Individual
Prefix:DR
First Name:SHANNON
Middle Name:
Last Name:FOLEY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1009 VALLEY ST
Mailing Address - Street 2:
Mailing Address - City:WAHPETON
Mailing Address - State:ND
Mailing Address - Zip Code:58075-3709
Mailing Address - Country:US
Mailing Address - Phone:605-203-1170
Mailing Address - Fax:
Practice Address - Street 1:103 9TH ST N STE 2
Practice Address - Street 2:
Practice Address - City:WAHPETON
Practice Address - State:ND
Practice Address - Zip Code:58075-4343
Practice Address - Country:US
Practice Address - Phone:701-642-8566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND2565122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist