Jennifer Hadra, DMD, MS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

12064 Issued in NC

Practice address

Shoreline Orthodontics
216 US-64
Manteo, NC 27954

Phone

(252) 216-2998

Fax

(252) 338-8184

NPI assigned

Feb 11, 2021

Last updated

Oct 29, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Credentials

Master of Science

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jennifer Hadra, DMD, PA

  dba Shoreline Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Manteo, NC
  • NPI 1720815335
  NPD Authorized official

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

{
    "created_epoch": "1613001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1295327179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2480",
            "city": "MANTEO",
            "state": "NC",
            "postal_code": "27954",
            "telephone_number": "252-216-2998",
            "fax_number": "252-338-8184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SHORELINE ORTHODONTICS",
            "address_2": "216 US-64",
            "city": "MANTEO",
            "state": "NC",
            "postal_code": "27954",
            "telephone_number": "252-216-2998",
            "fax_number": "252-338-8184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADRA",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "DMD, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-11",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NC",
            "license": "12064",
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "VA",
            "license": "0401417221",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas Lewis Frank, CRNA
• Heather Anne Freeland, CRNP
• Elizabeth Cloninger Gamiel, M.ED., CCC-SLP
• Jeri Denise Griggs, NP
• Jennifer Gwaltney, LCMHC
• Amanda Elizabeth Hall, M.S. CCC-SLP
• Christine Kennen Heard, MS, RD, LDN
• Heyder & Associates (Atlantic Dentistry)
• Samantha Leigh Hoback, LCSWA
• Linda Kathryn Hoffner, MS, CCC-SLP

• Orthodontics and Dentofacial Orthopedics Dentistry in Manteo, NC
• Providers in Manteo, NC by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; 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.