Dr. Shannitta Latrease Bridgers
Pediatric Dentist
1367 Walter Reed Rd Suite 103
Fayetteville
, North Carolina 28304
Dr. Shannitta Latrease Bridgers
Pediatric Dentist
1367 Walter Reed Rd Suite 103
Fayetteville
, North Carolina 28304
(910) 485-8398
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About
Features
Specialties
- Pediatric Dentist
Languages spoken
- English
Location
First Address
- Dr. Shannitta Latrease Bridgers
- 1367 Walter Reed Rd Ste 103
- Fayetteville, NC
- Zip : 28304-4445
- Fax : (910) 485-8398
- Phone : (910) 485-8749
Second Address
- Dr. Shannitta Latrease Bridgers
- 1367 Walter Reed Rd Suite 103
- Fayetteville, NC
- Zip : 28304
- Phone : (910) 485-8749
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Is Dr. Shannitta Latrease Bridgers a sole practitioner?
Is Dr. Shannitta Latrease Bridgers accepting new patients?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223P0221X | Pediatric Dentist | 8568 | NC |
National Provider Identifier
| NPI | 1083872915 |
|---|---|
| Provider Name | Dr. Shannitta Latrease Bridgers |
| First Address | Fayetteville, NC 28304-4445 |
| Second Address | Fayetteville, NC 28304 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 28/05/2008 |
| Last Update Date | 23/05/2018 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 5911135 | (05) | NC |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.