Active NPI
Shannon Rene Maddox, D.D.S.
- General Practice Dentistry
- Oklahoma City, OK
National Provider Identifier
1992017776
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 6212
- Practice address
- 10914 Hefner Pointe Dr
Suite 150
Oklahoma City, OK 73120-5066 - Phone
- (405) 946-5558
- NPI assigned
- Jul 8, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 6212 | OK | Primary |
Addresses
Primary practice location
10914 Hefner Pointe Dr
Suite 150
Oklahoma City, OK 73120-5066
Mailing address
10914 Hefner Pointe Dr
Suite 150
Oklahoma City, OK 73120-5066
Phone (405) 946-5558
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1278547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352937600000",
"number": "1992017776",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10914 HEFNER POINTE DR",
"address_2": "SUITE 150",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731205066",
"telephone_number": "405-946-5558"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10914 HEFNER POINTE DR",
"address_2": "SUITE 150",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731205066",
"telephone_number": "405-946-5558"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MADDOX",
"first_name": "SHANNON",
"middle_name": "RENE",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-07-08",
"last_updated": "2012-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OK",
"license": "6212",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.