Alice Louise Shaw, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D010382 Issued in AZ

Practice address

1714 W Hunt Hwy Ste 100
Queen Creek, AZ 85143-5245

Phone

(480) 882-3119

NPI assigned

Jun 5, 2019

Sex

Female

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 AZ

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

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.

• Skyline Dental Group and Orthodontics, LLP

  dba Skyline Dental Group and Orthodontics

  • General Practice Dentistry
  • Queen Creek, AZ
  • NPI 1811250301
  NPD (past)

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

{
    "created_epoch": "1559692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559692800000",
    "number": "1548828452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2827 W NORTHVIEW AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850517586",
            "telephone_number": "602-377-7754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1714 W HUNT HWY STE 100",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851435245",
            "telephone_number": "480-882-3119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "ALICE",
        "middle_name": "LOUISE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-05",
        "last_updated": "2019-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D010382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Serviam, LLC
• Hana Shaaban
• Judd A Shafer, MD
• Sharif Joes Transport, LLC
• Jared Allen Shaver, O.D.
• Rebecca Wynn Sheridan, RN
• Haissam Nayef Shiblak, RPH
• Amy Lee Shipp, ATC
• Christy Renee Shivers
• Deborah Lee Short, M.ED.

• General Practice Dentistry in Queen Creek, AZ
• Providers in Queen Creek, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2019; 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.