NPI 1083176275

Keyanni Jhamia Shaw, DDS

Practitioner Dentist Douglasville, GA

Practice location

Address: 6351 Douglas Blvd, Douglasville, GA 30135-7102
Phone: (404) 267-0400
Mailing address: 11409 Panhandle Rd, Hampton, GA 30228-1504

Registered specialties (2)

Dentist Primary

Dental Providers Taxonomy 122300000X Licence DN122281 (GA)

Other Dentist providers in Georgia →

General Practice Dentistry

Dental Providers Taxonomy 1223G0001X Licence DGD.9664 (SC)

Registry record

NPI: 1083176275
Entity type: Individual
Sex (as registered): Female
NPI issued: 5 Apr 2019
Record last updated: 22 Jul 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.