SHANNON LYNN JARDINA D.M.D.
NPI 1790019958
Dentist - General Practice in Vista, CA

Q: What is Shannon Jardina's NPI number?

The NPI number for Shannon Jardina is 1790019958. It was assigned to this individual provider in the NPPES registry on September 21, 2009.

Q: What is Shannon Jardina's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Q: When was this NPI record last updated?

The NPPES record for Shannon Jardina was last updated on July 18, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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 September 21, 2009PECOS Enrolled

1000 VALE TERRACE DR, VISTA, CA 92084(760) 631-5000 Get Directions Write a Review

NPPES record last updated: July 18, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Shannon Lynn Jardina D.m.d. NPPES

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

SHANNON LYNN JARDINA D.M.D. (NPI 1790019958) is an individual general practice provider in Vista, California, licensed in California (58569) and active in the NPI registry since September 2009. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1790019958

Entity TypeIndividualFemale

Primary Taxonomy1223G0001X

Provider Legal NameSHANNON LYNN JARDINACredential: D.M.D.

Location Address1000 VALE TERRACE DRVista, CA 92084-5218

Mailing Address1000 Vale Terrace DrVista, CA 92084-5218 · (760) 631-5000

Phone(760) 631-5000

Sole ProprietorNo

Enumeration DateSeptember 21, 2009

Last NPPES UpdateJuly 18, 2016

✔ NPI 1790019958 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in CA · 58569

Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

1000 VALE TERRACE DR, Vista, CA 92084

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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)

Shannon Lynn Jardina D.m.d. 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 92084 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

$94.87 typical visit price

range $62.10 – $184.71

Typical copayment $23.71 (range $15.52 – $46.17)

Most-billed visit code 99203

Established Patient

$76.87 typical visit price

range $20.62 – $151.42

Typical copayment $19.21 (range $5.15 – $37.85)

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.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHRISTINE DOUGHERTY LCSW

Social Worker (Clinical)