| Shane R. Claiborne, Dds, Pllc | |
|
16862 Forest Rd Forest VA 24551 | |
| (434) 944-9763 | |
| (434) 616-2277 |
| Full Name | Shane R. Claiborne, Dds, Pllc |
|---|---|
| Speciality | Dentist |
| Location | 16862 Forest Rd, Forest, Virginia |
| Authorized Official Name and Position | Shane R Claiborne (DENTIST/OWNER) |
| Authorized Official Contact | 4349449763 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shane R. Claiborne, Dds, Pllc 16862 Forest Road Forest VA 24551 Ph: (434) 944-9763 | Shane R. Claiborne, Dds, Pllc 16862 Forest Rd Forest VA 24551 Ph: (434) 944-9763 |
| NPI Number | 1073916334 |
|---|---|
| Provider Enumeration Date | 10/01/2014 |
| Last Update Date | 10/01/2014 |
| Medicare PECOS PAC ID | 9436548864 |
|---|---|
| Medicare Enrollment ID | O20211105000590 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073916334 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 0401410958 (Virginia) | Primary |
| Provider Name | Shane R Claiborne |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1275750119 PECOS PAC ID: 2163811597 Enrollment ID: I20211105000680 |
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