Shakasha L. Scruggs-Williams, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

28258 Issued in TX

Practice address

USA Dentac Fort Cavazos
36000 Shoemaker LN Suite 1051 RM 1048
Fort Cavazos, TX 76544-5054

Phone

(254) 287-2705

NPI assigned

Aug 28, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shakasha.scruggswilliams@direct.myhealthep.org

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.

• Au Medical Associates Inc

  • Multi-Specialty Clinic/Center
  • Augusta, GA
  • NPI 1841230620
  Medicare reassignment NPD
• Au Medical Associates Inc

  • Durable Medical Equipment & Medical Supplies
  • Augusta, GA
  • NPI 1114574126
  NPD

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

{
    "created_epoch": "1346112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1508114323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "USA DENTAC FORT CAVAZOS",
            "address_2": "36000 SHOEMAKER LN SUITE 1051 RM 1048",
            "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": "USA DENTAC FORT CAVAZOS",
            "address_2": "36000 SHOEMAKER LN SUITE 1051 RM 1048",
            "city": "FORT CAVAZOS",
            "state": "TX",
            "postal_code": "765445054",
            "telephone_number": "254-287-2705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCRUGGS-WILLIAMS",
        "first_name": "SHAKASHA",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-28",
        "last_updated": "2024-07-26",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "28258",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "10057",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "SC",
            "license": "10096",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "28258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Peter Schmitt, D.O.
• Seth Schuenemeyer
• William Allen Schumacher, DMD
• Jacqueline Joy Scott, DNP, ARNP, CNM, WHNP
• Satin Aramis Scott, LCSW
• Joshua Brian Seidel, DO
• Shenika Pritam Shah, DO
• Huon Sharpe
• Beau Joseph Shaw, DDS
• Sean Sheehey, D.O.

• Oral and Maxillofacial Surgery (Dentist) in Fort Cavazos, TX
• Providers in Fort Cavazos, TX by specialty
• Oral and Maxillofacial Surgery (Dentist) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2024; 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.