Beau Joseph Shaw, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

6954 Issued in OK

Practice address

36000 Shoemaker Lane, Suite 1051
Fort Cavazos, TX 76544-5054

Phone

(254) 287-2705

NPI assigned

Jul 19, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1500422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686614400000",
    "number": "1326561689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "US DENTAC HEALTH ACTIVITY FORT CAVAZOS",
            "address_2": "36000 SHOEMAKER LANE, SUITE 1051",
            "city": "FORT CAVAZOS",
            "state": "TX",
            "postal_code": "765445054",
            "telephone_number": "254-287-2705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36000 SHOEMAKER LANE, SUITE 1051",
            "city": "FORT CAVAZOS",
            "state": "TX",
            "postal_code": "765445054",
            "telephone_number": "254-287-2705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "BEAU",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-19",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "6954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Satin Aramis Scott, LCSW
• Shakasha L. Scruggs-Williams, DDS
• Joshua Brian Seidel, DO
• Shenika Pritam Shah, DO
• Huon Sharpe
• Sean Sheehey, D.O.
• John Brooke Shehan III, DO
• Peter Shellabarger, CRNA
• Jennifer E. Shepherd, RNC CPNP IBCLC
• Jillian Laverne Shute, DDS

• Dentist in Fort Cavazos, TX
• Providers in Fort Cavazos, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.