Madelyn Gray Shore, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

11837 Issued in NC

Practice address

271 Howard Blvd
Newport, NC 28570-7927

Phone

(252) 223-4161

NPI assigned

May 11, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Madelyn Shore, DMD, PLLC

  • General Practice Dentistry
  • Newport, NC
  • NPI 1174121099
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1589155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591833600000",
    "number": "1114549375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 DOGWOOD ST",
            "city": "ATLANTIC BEACH",
            "state": "NC",
            "postal_code": "285125104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "271 HOWARD BLVD",
            "city": "NEWPORT",
            "state": "NC",
            "postal_code": "285707927",
            "telephone_number": "252-223-4161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORE",
        "first_name": "MADELYN",
        "middle_name": "GRAY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-11",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "11837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Newport, NC
• Providers in Newport, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.