Shannon Herron-Grady

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D011474 Issued in AZ

Practice address

2025 S Arizona Ave
Yuma, AZ 85364-6549

Phone

(928) 782-3685

NPI assigned

Aug 18, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1660780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660780800000",
    "number": "1881312643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 S ARIZONA AVE",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853646549",
            "telephone_number": "928-782-3685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 S ARIZONA AVE",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853646549",
            "telephone_number": "928-782-3685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRON-GRADY",
        "first_name": "SHANNON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-18",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D011474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sonia Hernandez, LMT
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• Ivan Herrera
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• Luke William Hess
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• Margaret S Hiatt, LCSW
• Higher Way Integrative Therapy
• Dorothy L Higuera, M.ED.

• General Practice Dentistry in Yuma, AZ
• Providers in Yuma, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2022; 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.