Fredrick Shaw DDS, PC

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

17867 Issued in TX

Legal business name

FREDRICK SHAW DDS, PC

Practice address

1500 W 38TH St
Ste. 34
Austin, TX 78731-6321

Phone

(512) 451-7491

Fax

(512) 451-5388

NPI assigned

Jun 6, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Adrian F Ramos

Title

Insurance Coordinator

Phone

(512) 451-7491

Specialties & licenses 1

Addresses

Other names 1

• Shoal Creek Prosthodontic Group Other name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Fredrick Alexander Shaw III, D.D.S.

  • Prosthodontics
  • Austin, TX
  • NPI 1811006919
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213747200000",
    "number": "1073716338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 W 38TH ST",
            "address_2": "STE. 34",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787316321",
            "telephone_number": "512-451-7491",
            "fax_number": "512-451-5388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 W 38TH ST",
            "address_2": "STE. 34",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787316321",
            "telephone_number": "512-451-7491",
            "fax_number": "512-451-5388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREDRICK SHAW DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-06",
        "last_updated": "2008-06-18",
        "status": "A",
        "authorized_official_last_name": "RAMOS",
        "authorized_official_first_name": "ADRIAN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "INSURANCE COORDINATOR",
        "authorized_official_telephone_number": "512-451-7491",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": "TX",
            "license": "17867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shoal Creek Prosthodontic Group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Josephina Shea Fredericks
• Delora Marie Frederickson
• Ashlyn Archer Frederiksen, PA-C
• Leigh Anne Fredholm, MD
• Theresa Fredley, MS, FAAOMPT
• Kimberly Diane Fredrick, LPC
• Fredrickson Anesthesia Staffing Inc.
• Elizabeth A Fredrickson, LCSW
• Nichole Victoria Fredriksson Ellison, M.S. CCC-SLP
• Jeyton Freed

• Prosthodontics in Austin, TX
• Providers in Austin, TX by specialty
• Prosthodontics in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.