NPIMap

Organization Active NPI

Shawn a. Walls, DDS, PC

  • General Practice Dentistry
  • Johns Creek, GA
National Provider Identifier
1376929125
Registry record updated Aug 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
010715 Issued in GA
Legal business name
SHAWN A. WALLS, DDS, PC
Practice address
10700 Medlock Bridge Rd
Suite 202
Johns Creek, GA 30097-8456
Phone
(404) 444-8485
Fax
(770) 814-7407
NPI assigned
Aug 4, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2015

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

Authorized official

Name
Dr. Shawn A Walls, D.D.S.NPI 1952524316
Title
Owner/Ceo
Phone
(404) 444-8485

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 MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 010715 GA Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 9711 GA

Addresses

Primary practice location

10700 Medlock Bridge Rd
Suite 202
Johns Creek, GA 30097-8456

Mailing address

10700 Medlock Bridge Rd
Suite 202
Johns Creek, GA 30097-8456
Phone (404) 444-8485

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.

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1438646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438646400000",
    "number": "1376929125",
    "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": "300978456",
            "telephone_number": "404-444-8485",
            "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": "300978456",
            "telephone_number": "404-444-8485",
            "fax_number": "770-814-7407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAWN A. WALLS, DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-04",
        "last_updated": "2015-08-04",
        "status": "A",
        "authorized_official_last_name": "WALLS",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "404-444-8485",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "010715",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "9711",
            "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 Aug 4, 2015; 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.