SHADFAR FACIAL PLASTIC SURGERY LLC – NPI #1396636031
Otolaryngology

An otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions.

SHADFAR FACIAL PLASTIC SURGERY LLC is an otolaryngologist located in EDMOND, OK. NPPES has assigned the NPI number 1396636031 to SHADFAR FACIAL PLASTIC SURGERY LLC on July 11, 2025. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207YX0905X from the Health Care Provider Taxonomy code set, which is classified as Otolaryngology, specializing in Otolaryngology/Facial Plastic Surgery

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for SHADFAR FACIAL PLASTIC SURGERY LLC below.

NPI Profile for
SHADFAR FACIAL PLASTIC SURGERY LLC

NPI Number
1396636031
Enumeration Date

(about 11 months ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
SHADFAR FACIAL PLASTIC SURGERY LLC
Primary location
4509 INTEGRIS PKWY STE 350
EDMOND, OK 73034-8696
Phone: (405) 534-4358 Fax: (405) 657-3896
Mailing address
225 NATURE LN
EDMOND, OK 73034-3461
Phone: Fax:
Organization Subpart
No
Authorized Official
SCOTT SHADFAR
MANAGER
Phone: (405) 834-3275
Updated
Certification Date
Jul 11, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207YX0905X
- Otolaryngology / Otolaryngology/Facial Plastic Surgery (Primary)
207Y00000X
- Otolaryngology

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.