Doctor profile · Federal record
Dr. Shane Wilson
Dentist · Gravois Mills, MO
- NPI 1780334664
- 4 yrs on file
- Male
- Group practice
- No sanctions
Practice & contact
- Primary practice
-
110 Watson Cir
Gravois Mills, MO 650374625
(763) 528-5539
Credentials & registration
- NPI registered
- March 2022 — 4 yrs on file
- Profile last updated
- June 6, 2022
- Specialty taxonomy
- 122300000X — NUCC code
- State license (1)
- Missouri #2022019208
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1780334664. Last verified May 11, 2026.Open Payments
Industry payments received
All-time total
$39
Transactions
1
Manufacturers
1
| Payer (manufacturer) | Industry | Txns | Amount |
|---|---|---|---|
| Align Technology, Inc. | 1 | $38.54 |
By nature of payment
Medicare Part D · 2023
Top prescriptions
Total claims
97
Patients
69
Total drug cost
$286
| Drug | Type | Claims | Patients | Total cost |
|---|---|---|---|---|
| Amoxicillin | Generic | 86 | 69 | $256 |
| Azithromycin | Generic | 11 | 0 | $31 |
Frequently asked questions
What is Dr. Shane Wilson's medical specialty?
Dr. Shane Wilson practices Dentist in Gravois Mills, MO.
Where does Dr. Shane Wilson practice?
Dr. Shane Wilson practices at 110 Watson Cir, Gravois Mills, MO 650374625. Office phone: 7635285539.
What is Dr. Shane Wilson's NPI?
Dr. Shane Wilson's National Provider Identifier (NPI) is 1780334664, issued by NPPES.