Shadae Person, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

0401415686 Issued in VA

Practice address

18070 S Tamiami TRL Ste 14
Fort Myers, FL 33908-4602

Phone

(239) 288-7275

NPI assigned

Jun 18, 2017

Last updated

Sep 30, 2021By 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 3

Addresses

Other names 1

• Shadae Anderson Former name

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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

• Person Dental PLLC

  dba Harmony Dental Studio

  • Dental Clinic/Center
  • Bonita Springs, FL
  • NPI 1851285373
  NPD Authorized official

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

{
    "created_epoch": "1497744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632960000000",
    "number": "1326578865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18070 S TAMIAMI TRL STE 14",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339084602",
            "telephone_number": "239-288-7275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18070 S TAMIAMI TRL STE 14",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339084602",
            "telephone_number": "239-288-7275"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "215 Roanoke St",
            "address_purpose": "LOCATION",
            "city": "Christiansburg",
            "state": "VA",
            "postal_code": "240733025",
            "country_code": "US",
            "telephone_number": "540-381-0820",
            "fax_number": "540-381-3391",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERSON",
        "first_name": "SHADAE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-18",
        "last_updated": "2021-09-30",
        "certification_date": "2021-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN24803",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401415686",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401415686",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHADAE",
            "last_name": "ANDERSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kaila Perrington
• Anileidy C Perry-Diaz
• Jenevieve Perry, APRN
• Ryan M Perry, DO
• Susan Persia, MS OTR/L
• Personalized Health Care Inc
• Albert Richard Pescitelli, M.D.
• Peter a Lewis Internal Medicine Plus, PL (Internal Medicine Plus)
• Joselyn Peters, LMHC
• Pamela Williams Peters, M.A., L.M.H.C.

• Dentist in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.