Nikky Shotwell, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DN014728 Issued in GA

Practice address

5461 Meridian Mark Rd Ste 200
Atlanta, GA 30342-4014

Phone

(404) 785-2072

Fax

(404) 785-5892

NPI assigned

Apr 21, 2014

Last updated

Jun 6, 2022By the provider in NPPES

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

Electronic endpoints 1

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

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

{
    "created_epoch": "1398038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1679993430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5461 MERIDIAN MARK RD STE 200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303424014",
            "telephone_number": "404-785-2072",
            "fax_number": "404-785-5892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5461 MERIDIAN MARK RD STE 200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303424014",
            "telephone_number": "404-785-2072",
            "fax_number": "404-785-5892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOTWELL",
        "first_name": "NIKKY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-21",
        "last_updated": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "GA",
            "license": "DN014728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "choa@choa.gadirect.net",
            "affiliation": "N",
            "address_1": "5461 Meridian Mark Rd Ste 200",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303424014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jennifer Short, PA
• Louise Joy Short, MD
• Mary Anne Elizabeth Short, APC, NCC
• Brenda Shorter, NP-C, NNP-BC
• Hannah Shotwell, RN
• Roy Lucien Shouse, M.D.
• Rebecca Showalter, NP
• Joi G Showell, PHD, LCSW
• Jay D. Shray, PA-C
• Roshan Shrestha, MD

• Pediatric Dentistry in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Pediatric Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2022; 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.