Malcolm Drew Shabo, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7631 Issued in TN

Practice address

5958 Snow Hill Rd
Ste 144 PMB 204
Ooltewah, TN 37363-7833

Phone

(423) 894-4084

Fax

(423) 894-4086

NPI assigned

Mar 28, 2007

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Rest Assured LLC

  • Durable Medical Equipment & Medical Supplies
  • Cleveland, TN
  • NPI 1982255345
  NPD Authorized official

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361750400000",
    "number": "1790804367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8307 WATERSBEND LN",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373638705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5958 SNOW HILL RD",
            "address_2": "STE 144 PMB 204",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373637833",
            "telephone_number": "423-894-4084",
            "fax_number": "423-894-4086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHABO",
        "first_name": "MALCOLM",
        "middle_name": "DREW",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-28",
        "last_updated": "2013-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "7631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Molly Jill Scott
• Tyler Scott
• Elhassan Sebbana
• Christine Seidenstricker, RDH
• Sentef Medical Center
• Cynthia Fernandez Shaffer, NP-C
• Emma Jean Shelby
• Tara L Shepherd, RDH
• Allen T Sherwood, M.D.
• Diane Allen Shuck

• General Practice Dentistry in Ooltewah, TN
• Providers in Ooltewah, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2013; 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.