Dante Sandlin Shaw, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0001314 Issued in GA

Practice address

750 Longleaf Blvd
Suite D
Lawrenceville, GA 30045-8459

Phone

(404) 556-4226

Fax

(770) 963-7490

NPI assigned

Nov 26, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1164499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841366630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 LAUREL LAKE DR",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300244317",
            "telephone_number": "404-556-4226",
            "fax_number": "770-963-7490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 LONGLEAF BLVD",
            "address_2": "SUITE D",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300458459",
            "telephone_number": "404-556-4226",
            "fax_number": "770-963-7490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "DANTE",
        "middle_name": "SANDLIN",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "0001314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shiva Sharma, MD
• Veena Paras Sharma, PHARM D
• Patrick Shaul
• April Shavkin
• Shaw Doula Services (Shaw Doula Services and Advocacy)
• Jane Deborah Shaw, OTR
• Roxann Latoya Shaw, CRNA
• Kimberly Theresa Shea-Carter, CNM
• Kathleen A Sheerin, MD
• Logan Sheffield, BCBA

• Clinical Psychologist in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Clinical Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.