S. Shembo Etienne, D.D.D., P.a.

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

S. SHEMBO ETIENNE, D.D.D., P.A.

Practice address

10400 Mallard Creek Rd
Suite 103
Charlotte, NC 28262-9772

Phone

(704) 996-8608

NPI assigned

Apr 23, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Shango Shembo Etienne, D.D.S.NPI 1770994345

Title

Owner

Phone

(704) 996-8608

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shango Shembo Etienne, D.D.S

  • General Practice Dentistry
  • Charlotte, NC
  • NPI 1770994345
  NPD (past) Authorized official

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

{
    "created_epoch": "1429747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429747200000",
    "number": "1326435678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10400 MALLARD CREEK RD",
            "address_2": "SUITE 103",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282629772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10400 MALLARD CREEK RD",
            "address_2": "SUITE 103",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282629772",
            "telephone_number": "704-996-8608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S. SHEMBO ETIENNE, D.D.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-23",
        "last_updated": "2015-04-23",
        "status": "A",
        "authorized_official_last_name": "ETIENNE",
        "authorized_official_first_name": "SHANGO",
        "authorized_official_middle_name": "SHEMBO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-996-8608",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• S. W. Webber, III, DDS, PA
• S.J.Burrow,III.D.D.S.,M.S.,P.L.L.C.

• Dentist in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Dentist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2015; 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.