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DR. SHADOE STEWART DDS
NPI 1700515632
Dentist - Periodontics in Greensboro, NC

Active since June 07, 2022Opted out of Medicare · through Jul 14, 2027
1591 YANCEYVILLE ST STE 300B, GREENSBORO, NC 27405(336) 274-1950(336) 274-1951 Get Directions Write a Review

NPPES record last updated: March 26, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 26, 2026, Jun 7, 2022 (2 updates tracked since 2022).

About Dr. Shadoe Stewart Dds NPPES

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

DR. SHADOE STEWART DDS (NPI 1700515632) is an individual periodontics provider in Greensboro, North Carolina, licensed in North Carolina (12739) and active in the NPI registry since June 2022. He has opted out of Medicare through July 14, 2027.

NPPES Registry Identity

NPI1700515632
Entity TypeIndividualMale
Primary Taxonomy1223P0300X
Provider Legal NameDR. SHADOE STEWARTCredential: DDS
Location Address1591 YANCEYVILLE ST STE 300BGreensboro, NC 27405-6944
Mailing Address1591 Yanceyville St Ste 300bGreensboro, NC 27405-6944 · (336) 274-1950 · Fax (336) 274-1951
Phone(336) 274-1950
Fax(336) 274-1951
Sole ProprietorYes
Enumeration DateJune 7, 2022
Last NPPES UpdateMarch 26, 20262 updates tracked since enumeration
NPPES CertifiedMarch 26, 2026
✔ NPI 1700515632 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · PeriodonticsDental Providers
Taxonomy Code1223P0300X
License✔ Licensed in NC · 12739
Definition
That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.
Also ListedDentistTaxonomy 122300000X · License 12739 (NC)
1591 YANCEYVILLE ST STE 300B, Greensboro, NC 27405
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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. Shadoe Stewart Dds 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 July 14, 2025 through July 14, 2027.

Opt-Out Effective DateJuly 14, 2025
Opt-Out In Effect ThroughJuly 14, 2027Opt-out affidavits renew automatically every two years unless cancelled

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 Shadoe Stewart's NPI number?

The NPI number for Shadoe Stewart is 1700515632. It was assigned to this individual provider in the NPPES registry on June 7, 2022.

Where is Shadoe Stewart located?

Shadoe Stewart practices at 1591 Yanceyville St Ste 300B, Greensboro, NC 27405. The listed phone number is (336) 274-1950.

What is Shadoe Stewart's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

Is Shadoe Stewart enrolled in Medicare?

No. Shadoe Stewart has opted out of Medicare through July 14, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Shadoe Stewart was last updated on March 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.