SHAWN TIMOTHY MCCULLOUGH DDS
NPI 1023171196
Dentist in North Branch, MN

Q: What is Shawn Mccullough's NPI number?

The NPI number for Shawn Mccullough is 1023171196. It was assigned to this individual provider in the NPPES registry on December 19, 2006.

Q: What is Shawn Mccullough's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Q: When was this NPI record last updated?

The NPPES record for Shawn Mccullough was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since December 19, 2006PECOS Enrolled

6041 MAIN STREET, SUITE C, NORTH BRANCH, MN 55056(651) 674-4811(651) 277-0411 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 23, 2026.

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About Shawn Timothy Mccullough Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHAWN TIMOTHY MCCULLOUGH DDS (NPI 1023171196) is an individual dentist in North Branch, Minnesota, licensed in Minnesota (011245) and active in the NPI registry since December 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1023171196

Entity TypeIndividualMale

Primary Taxonomy122300000X

Provider Legal NameSHAWN TIMOTHY MCCULLOUGHCredential: DDS

Location Address6041 MAIN STREET, SUITE CNorth Branch, MN 55056

Mailing AddressPo Box 40, 6041 Main Street Suite CNorth Branch, MN 55056 · (651) 674-4811 · Fax (651) 277-0411

Phone(651) 674-4811

Fax(651) 277-0411

Sole ProprietorNo

Enumeration DateDecember 19, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1023171196 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in MN · 011245

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

6041 MAIN STREET, North Branch, MN 55056

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shawn Timothy Mccullough Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55056 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.82 typical visit price

range $56.00 – $168.28

Typical copayment $21.45 (range $14.00 – $42.07)

Most-billed visit code 99203

Established Patient

$69.74 typical visit price

range $18.32 – $138.04

Typical copayment $17.43 (range $4.58 – $34.51)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shawn Mccullough's NPI number?

The NPI number for Shawn Mccullough is 1023171196. It was assigned to this individual provider in the NPPES registry on December 19, 2006.

Where is Shawn Mccullough located?

Shawn Mccullough practices at 6041 Main Street Suite C, North Branch, MN 55056. The listed phone number is (651) 674-4811.

What is Shawn Mccullough's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Shawn Mccullough enrolled in Medicare?

Yes. Shawn Mccullough is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Shawn Mccullough was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.