Individual provider Active NPI

Rachel Kara Jolley Shaw, D.M.D.

  • General Practice Dentistry
  • Glendale, AZ
National Provider Identifier
1083092571
Registry record updated Dec 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D012669 Issued in AZ
Practice address
5855 W Utopia Rd
Glendale, AZ 85308-5251
Phone
(623) 537-6000
NPI assigned
May 15, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D012669 AZ Primary

Addresses

Primary practice location

5855 W Utopia Rd
Glendale, AZ 85308-5251

Mailing address

5855 W Utopia Rd
Glendale, AZ 85308-5251
Phone (623) 537-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160223000625 UT Order and Referring Only - DentistPractitioner - Dentist 5193020568

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D012669AZMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Midwestern University CurrentSince Dec 21, 2025 Accepting new patients
Midwestern University PastSince Dec 21, 2025 Accepting new patients
Springville Dentistry General Practice Past Accepting new patients

Locations

5855 W Utopia Rd
Glendale, AZ 85308
Phone (623) 806-7000

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1431648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766102400000",
    "number": "1083092571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5855 W UTOPIA RD",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853085251",
            "telephone_number": "623-537-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5855 W UTOPIA RD",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853085251",
            "telephone_number": "623-537-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "RACHEL",
        "middle_name": "KARA JOLLEY",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-15",
        "last_updated": "2025-12-19",
        "certification_date": "2025-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D012669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.