NPIMap

Organization Active NPI

Shawn a. Walls, DDS, PC

  • General Practice Dentistry
  • Johns Creek, GA
National Provider Identifier
1093411910
Registry record updated May 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
SHAWN A. WALLS, DDS, PC
Practice address
10700 Medlock Bridge Rd.
Suite 202
Johns Creek, GA 30097
Phone
(770) 813-0079
Fax
(770) 814-7407
NPI assigned
Feb 2, 2023
Last updated
May 2, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2023

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

Authorized official

Name
Shawn A Walls, DDSNPI 1952524316
Title
President/Dentist
Phone
(770) 813-0079

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

10700 Medlock Bridge Rd.
Suite 202
Johns Creek, GA 30097

Mailing address

10700 Medlock Bridge Rd.
Suite 202
Johns Creek, GA 30097
Phone (770) 813-0079

National Provider Directory

National Provider Directory
Tax ID family
Shawn a Walls DDS PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

10700 Medlock Bridge Rd
Ste 202
Johns Creek, GA 30097
Phone (770) 813-0079

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1675296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682985600000",
    "number": "1093411910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10700 MEDLOCK BRIDGE RD.",
            "address_2": "SUITE 202",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "30097",
            "telephone_number": "770-813-0079",
            "fax_number": "770-814-7407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10700 MEDLOCK BRIDGE RD.",
            "address_2": "SUITE 202",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "30097",
            "telephone_number": "770-813-0079",
            "fax_number": "770-814-7407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAWN A. WALLS, DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-02",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A",
        "authorized_official_last_name": "WALLS",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT/DENTIST",
        "authorized_official_telephone_number": "770-813-0079",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johns Creek, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2023; 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.