Keyanni Jhamia Shaw, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DN122281 Issued in GA

Practice address

6351 Douglas Blvd
Douglasville, GA 30135-7102

Phone

(404) 267-0400

NPI assigned

Apr 5, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Hope First Investments

  dba Hope 1st Pharmacy

  • Pharmacy
  • Atlanta, GA
  • NPI 1861114977
  NPD (past)
• Love Your Smile LLC

  dba Aspen Dental

  • Dentist
  • Douglasville, GA
  • NPI 1578001384
  NPD (past)
• The Good Samaritan Health Center, Inc.

  • Primary Care Clinic/Center
  • Atlanta, GA
  • NPI 1629254008

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1554422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626912000000",
    "number": "1083176275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11409 PANHANDLE RD",
            "city": "HAMPTON",
            "state": "GA",
            "postal_code": "302281504",
            "telephone_number": "770-572-4915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6351 DOUGLAS BLVD",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301357102",
            "telephone_number": "404-267-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "KEYANNI",
        "middle_name": "JHAMIA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-05",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "DGD.9664",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN122281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Serenity Seekers, LLC
• Moncerrat Serna-Melchor
• Sabrina Elizabeth Serna, IBCLC, RLC
• Reagan Sexton
• Maria Mohammed Javed Shaikh, M.D.
• Sheila Gowdy OD PC
• Alicia Shelly, M.D.
• Sheltered Cove Counseling Center Inc
• Sherri Shelton-Johnson, PT
• Denese Shelton, DDS

• Dentist in Douglasville, GA
• Providers in Douglasville, GA by specialty
• Dentist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2021; 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.