Provider Demographics
NPI:1669817086
Name:SHOPE, ANNA LEWIS (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:LEWIS
Last Name:SHOPE
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 1:212 WOODSTAFF AVE
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-9802
Mailing Address - Country:US
Mailing Address - Phone:336-601-2000
Mailing Address - Fax:
Practice Address - Street 1:8450 LOUISBURG RD STE 130
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27616-5884
Practice Address - Country:US
Practice Address - Phone:919-266-5332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-30
Last Update Date:2023-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC93311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice