Kim Leslie Shaw, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN12463 Issued in FL

Practice address

9105 Town Center Pkwy
Lakewood Ranch, FL 34202-5141

Phone

(941) 538-6064

Fax

(941) 538-6064

NPI assigned

Jun 4, 2007

Sex

Male

Sole proprietor

No

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

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

State licenses

Networks

• Freedom Health HMO Network

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786492800000",
    "number": "1457553265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14249",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342804249",
            "telephone_number": "941-224-0698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9105 TOWN CENTER PKWY",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342025141",
            "telephone_number": "941-538-6064",
            "fax_number": "941-538-6064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "KIM",
        "middle_name": "LESLIE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-04",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN12463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alisha Sexton, LMT
• Nancy Shahan
• Christopher Shalhoub, RPH
• Robert John Shamsey, MD
• Edna Shaw, COTA
• Michael J Shereff, MD
• Sheridan Children'S Healthcare Services, Inc
• Sheridan Emergency Physician Services, Inc
• Lilly Short
• Miranda Sikorski

• General Practice Dentistry in Lakewood Ranch, FL
• Providers in Lakewood Ranch, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.