Individual provider Active NPI

Shanhai Heywood, DMD

  • Dentist
  • Decatur, AL
National Provider Identifier
1477246627
Registry record updated Jun 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D.007482-C1 Issued in AL
Practice address
1318 Stratford Rd SE Ste a
Decatur, AL 35601-6026
Phone
(801) 298-3230
NPI assigned
Jun 1, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dentist 122300000X D.007482-C1 AL Primary

Addresses

Primary practice location

1318 Stratford Rd SE Ste a
Decatur, AL 35601-6026

Mailing address

1318 Stratford Rd SE Ste a
Decatur, AL 35601-6026

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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

Enrollment IDStateProvider typePAC IDDetails
I20240923004125 UT Order and Referring Only - DentistPractitioner - Dentist 1658812250

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D.007482-C1ALMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Centerville Dental Group, LLP General Practice PastSince Jun 1, 2024 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1685577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750118400000",
    "number": "1477246627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1318 STRATFORD RD SE STE A",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356016026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1318 STRATFORD RD SE STE A",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356016026",
            "telephone_number": "801-298-3230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEYWOOD",
        "first_name": "SHANHAI",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-01",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AL",
            "license": "D.007482-C1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, AL

Sources for this page

Verify at the official NPI Registry.