Shanna Burress, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

8843 Issued in KY

Practice address

1109 State St
Bowling Green, KY 42101-2648

Phone

(270) 781-8039

NPI assigned

Sep 26, 2007

Last updated

Mar 7, 2012By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

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

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.

• Pennyroyal Healthcare Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Hopkinsville, KY
  • NPI 1124319942
  Medicare reassignment NPD
• Pennyroyal Healthcare Services, Inc

  dba Community Dental

  • Federally Qualified Health Center (FQHC)
  • Hopkinsville, KY
  • NPI 1104532332

  Dentist

  NPD
• Pennyroyal Healthcare Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Oak Grove, KY
  • NPI 1720454507
  NPD

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

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331078400000",
    "number": "1336336098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "546 CERTAIN LN",
            "city": "GLASGOW",
            "state": "KY",
            "postal_code": "421417742",
            "telephone_number": "270-646-8966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 STATE ST",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421012648",
            "telephone_number": "270-781-8039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURRESS",
        "first_name": "SHANNA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-26",
        "last_updated": "2012-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "8843",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100147050",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janie Marie Burnett, BCBA
• Jerhett Burney, APSS
• Kyra Ann Burns
• Laura Ann Burns, MS, CCC-SLP
• Meghann Fitzpatrick Burns
• Ella Louise Burroughs
• Julianna L Burroughs, RBT
• Andrew Madison Burt, D.M.D
• Gerald Burt, PT, DPT
• James R. Burt, M.D.

• Dentist in Bowling Green, KY
• Providers in Bowling Green, KY by specialty
• Dentist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2012; 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.