| NPI | 1114710472 |
|---|---|
| NPI Type | NPI-2 Organization |
| Status | Active |
| Enumeration Date | 2025-05-28 |
| Last Updated | 2025-05-28 |
| Authorized Official | Allison Jarrell Practice Leader Phone: 3362731000 |
| Mailing Address | 2105 Braxton Ln Ste 102 Greensboro, NC 27408-2863 United States 📍 View Map |
| Primary Practice Address | 2105 Braxton Ln Ste 102 Greensboro, NC 27408-2863 United States Phone: (336) 273-1000 📍 View Map |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| Yes | 204E00000X – Oral & Maxillofacial Surgery | - | - |
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About NPI 1114710472
Shenan Bradshaw Dds Md Pa is an organization registered in the CMS NPPES NPI Registry with NPI number 1114710472. The primary specialty listed is Oral & Maxillofacial Surgery. The organization is located in Greensboro, NC. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2025-05-28. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1114710472?
NPI 1114710472 belongs to Shenan Bradshaw Dds Md Pa, a Oral & Maxillofacial Surgery in Greensboro, NC. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.
Is NPI 1114710472 active?
The current status of NPI 1114710472 in the NPPES registry is Active. The record was last updated on 2025-05-28.
What specialty is NPI 1114710472?
NPI 1114710472 is classified under the taxonomy Oral & Maxillofacial Surgery. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1114710472?
You can verify NPI 1114710472 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1114710472?
The primary practice address on file for NPI 1114710472 is 2105 Braxton Ln Ste 102, Greensboro, NC 27408-2863. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1114710472 issued?
NPI 1114710472 was first issued (enumerated) on 2025-05-28. The NPPES record was last updated on 2025-05-28.
Practice Location Map
Shenan Bradshaw Dds Md Pa is located at 2105 Braxton Ln Ste 102, Greensboro, NC. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Shenan Bradshaw Dds Md Pa. All records sourced from the CMS NPPES registry.