Provider Demographics
NPI:1083876189
Name:PATTERSON, SHAWANA NEOPI (DDS)
Entity Type:Individual
Prefix:
First Name:SHAWANA
Middle Name:NEOPI
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2705 CROQUET CIR
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-5017
Mailing Address - Country:US
Mailing Address - Phone:202-607-1535
Mailing Address - Fax:
Practice Address - Street 1:801 PHILLIPS AVE STE 101
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-7293
Practice Address - Country:US
Practice Address - Phone:336-812-3104
Practice Address - Fax:336-812-3105
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-30
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC92481223S0112X
DCDEN10004951223S0112X
MD137201223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery