Benjamin Andy Shirley, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

7519 Issued in LA

Practice address

1067 Twining Dr
Barksdale Afb, LA 71110-2486

Phone

(318) 456-6718

NPI assigned

Jul 13, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

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 and National Provider Directory roles.

• Lsu Health Sciences Center Shreveport Faculty Group Practice

  • Family Medicine Physician
  • Shreveport, LA
  • NPI 1013374222

  Oral & Maxillofacial Surgery

  Medicare reassignment NPD

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

{
    "created_epoch": "1247443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748304000000",
    "number": "1801025770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1067 TWINING DR",
            "city": "BARKSDALE AFB",
            "state": "LA",
            "postal_code": "711102486",
            "telephone_number": "318-456-6718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1067 TWINING DR",
            "city": "BARKSDALE AFB",
            "state": "LA",
            "postal_code": "711102486",
            "telephone_number": "318-456-6718"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 Fisher St Bldg 468",
            "address_purpose": "LOCATION",
            "city": "Biloxi",
            "state": "MS",
            "postal_code": "395342508",
            "country_code": "US",
            "telephone_number": "228-376-0511",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "301 Fisher St Bldg 468",
            "address_purpose": "LOCATION",
            "city": "Biloxi",
            "state": "MS",
            "postal_code": "395342508",
            "country_code": "US",
            "telephone_number": "228-376-0511",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "RAF Lakenheath 48 MDG/SGHC",
            "address_2": "Unit 5115",
            "address_purpose": "LOCATION",
            "city": "APO",
            "state": "AE",
            "postal_code": "094615115",
            "country_code": "US",
            "telephone_number": "334-226-8033",
            "country_name": "United States",
            "address_type": "MIL"
        },
        {
            "address_1": "1541 Kings Hwy",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711034228",
            "country_code": "US",
            "telephone_number": "318-626-0000",
            "fax_number": "318-629-4833",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Unit 5071 Box Mdg",
            "address_purpose": "LOCATION",
            "city": "APO",
            "state": "AP",
            "postal_code": "963285071",
            "country_code": "US",
            "telephone_number": "315-225-7508",
            "country_name": "United States",
            "address_type": "MIL"
        }
    ],
    "basic": {
        "last_name": "SHIRLEY",
        "first_name": "BENJAMIN",
        "middle_name": "ANDY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-13",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "23971",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "LA",
            "license": "7519",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "LA",
            "license": "7519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bo K. Romero
• Diane Marie Rump, DPT
• Kim Michael Schoeffel, D.O.
• Charles Wayne Sheffield, IDMT
• Ashley Ivey Shields, DMD
• Brian W Signal
• Laura Simpkins, PH.D.
• Argie Sircar-Valdez
• John Smith, DDS
• Jonathan Snow

• Oral and Maxillofacial Surgery (Dentist) in Barksdale Afb, LA
• Providers in Barksdale Afb, LA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2025; 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.