Healthcare Provider Details

I. General information

NPI: 1922468941
Provider Name (Legal Business Name): SHANNON MARGARET SNIPE D.M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/03/2016
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

136 FAIRVIEW RD
MOORESVILLE NC
28117-9517
US

IV. Provider business mailing address

276 GILEAD RD
HUNTERSVILLE NC
28078-6897
US

V. Phone/Fax

Practice location:
  • Phone: 704-662-0021
  • Fax:
Mailing address:
  • Phone: 843-813-3968
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number10432
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: