Gregory Farris Shanbour, D.D.S.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

6549 Issued in OK

Practice address

604B Nexton Square Dr
Summerville, SC 29486-7914

Phone

(405) 650-0337

NPI assigned

Apr 24, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Gregory S. Shanbour, D.D.S., M.S.

  • Periodontics
  • Oklahoma City, OK
  • NPI 1003080037
  NPD (past)

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

{
    "created_epoch": "1335225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1144588559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604B NEXTON SQUARE DR",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294867914",
            "telephone_number": "405-650-0337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604B NEXTON SQUARE DR",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294867914",
            "telephone_number": "405-650-0337"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8117 S Walker Ave",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731399476",
            "country_code": "US",
            "telephone_number": "405-634-2239",
            "fax_number": "405-634-3598",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHANBOUR",
        "first_name": "GREGORY",
        "middle_name": "FARRIS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-24",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "OK",
            "license": "6549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Periodontics in Summerville, SC
• Providers in Summerville, SC by specialty
• Periodontics in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2025; 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.