Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Shannon Harris Wailes, DDS

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1588203392

Dr. Shannon Harris Wailes, DDS is a Student in an Organized Health Care Education/Training Program in Redlands, California. Practices as a sole proprietor and works from 2 locations. Licensed in California.

Licensed in
CA
In the registry since
2019
Specialties on file
2
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

605 Esther Way
Redlands, CA 92373-5821
Phone: (760) 716-5280
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1545 Atlantic Ave, Brooklyn, NY 11213-1122 — (718) 613-7140

Specialties & licences

Orthodontics and Dentofacial Orthopedics Dentistry (primary) Taxonomy 1223X0400X · Licence DDS110012 (CA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1588203392
Entity typeIndividual (Type 1)
GenderFemale
Credentials DDS
Sole proprietorYes
NPI enumeratedDecember 26, 2019
Last updated in NPPESAugust 6, 2024
Certification dateAugust 6, 2024

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