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DR. SHENAN MARIE BRADSHAW DDS, MD
NPI 1699040121
Dentist - Oral and Maxillofacial Surgery in Chesterfield, MO

Active since March 16, 2012Opted out of Medicare · through Apr 7, 2028
17300 N OUTER 40 RD STE 103, CHESTERFIELD, MO 63005(636) 536-5158 Get Directions Write a Review

NPPES record last updated: January 18, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 19, 2019, Jan 24, 2016 (2 updates tracked since 2016).

About Dr. Shenan Marie Bradshaw Dds, Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SHENAN MARIE BRADSHAW DDS, MD (NPI 1699040121) is an individual oral and maxillofacial surgery provider in Chesterfield, Missouri, licensed in Missouri (2020029150) and active in the NPI registry since March 2012. She has opted out of Medicare through April 7, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1699040121
Entity TypeIndividualFemale
Primary Taxonomy1223S0112X
Provider Legal NameDR. SHENAN MARIE BRADSHAWCredential: DDS, MD
Location Address17300 N OUTER 40 RD STE 103Chesterfield, MO 63005-1364
Mailing Address17300 N Outer 40 Rd Ste 103Chesterfield, MO 63005-1364 · (636) 536-5158
Phone(636) 536-5158
Sole ProprietorYes
Enumeration DateMarch 16, 2012
Last NPPES UpdateJanuary 18, 20252 updates tracked since enumeration
NPPES CertifiedJanuary 18, 2025
✔ NPI 1699040121 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License✔ Licensed in MO · 2020029150
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
17300 N OUTER 40 RD STE 103, Chesterfield, MO 63005
Open in Google Maps ↗

Other Identifiers 2

Other2021010068MO · Medical License
Other2020029150MO · Dental License

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Shenan Marie Bradshaw Dds, Md has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 7, 2022 through April 7, 2028.

Opt-Out Effective DateApril 7, 2022
Opt-Out In Effect ThroughApril 7, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63005 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$86.32 typical visit price
range $55.65 – $169.38
Typical copayment $21.58 (range $13.91 – $42.34)
Most-billed visit code 99203
Established Patient
$69.50 typical visit price
range $17.76 – $137.92
Typical copayment $17.37 (range $4.44 – $34.48)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DRAKE WESTON CONNER DDS, MD
Dentist (Oral and Maxillofacial Surgery)
17300 N OUTER 40 RD STE 103
CHESTERFIELD, MO 63005
St. Louis County (636) 223-5101

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shenan Bradshaw's NPI number?

The NPI number for Shenan Bradshaw is 1699040121. It was assigned to this individual provider in the NPPES registry on March 16, 2012.

Where is Shenan Bradshaw located?

Shenan Bradshaw practices at 17300 N Outer 40 Rd Ste 103, Chesterfield, MO 63005. The listed phone number is (636) 536-5158.

What is Shenan Bradshaw's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Shenan Bradshaw enrolled in Medicare?

No. Shenan Bradshaw has opted out of Medicare through April 7, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

What insurance does Shenan Bradshaw accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 8 other insurers list Shenan Bradshaw as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Shenan Bradshaw was last updated on January 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.