Randall Loren Shaw, D.D.S.,M.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

29010.013819 Issued in MI

Practice address

18860 W 10 Mile Rd
Southfield, MI 48075-2666

Phone

(248) 565-3331

NPI assigned

Aug 19, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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.

• Office 2 PLLC

  • Dental Clinic/Center
  • Lansing, MI
  • NPI 1336654805
  NPD Authorized official
• Office 3 PLLC

  • Dental Clinic/Center
  • Livonia, MI
  • NPI 1528567401
  NPD Authorized official
• Office 5 PLLC

  • Public Health Dentistry
  • South Lyon, MI
  • NPI 1407450877

  Single Specialty

  NPD Authorized official

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

{
    "created_epoch": "1219104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606176000000",
    "number": "1891942165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 PINE RIDGE DR",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483042139",
            "telephone_number": "248-931-1151",
            "fax_number": "248-594-2221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18860 W 10 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480752666",
            "telephone_number": "248-565-3331"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "33627 7 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Livonia",
            "state": "MI",
            "postal_code": "481523077",
            "country_code": "US",
            "telephone_number": "248-471-1555",
            "fax_number": "248-471-4146",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAW",
        "first_name": "RANDALL",
        "middle_name": "LOREN",
        "credential": "D.D.S.,M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-19",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MI",
            "license": "13819",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MI",
            "license": "29010.013819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yolanda Shavers
• Shaw-Draves Psychological Services
• Amanda D Shaw
• Arguster Shaw, LLMSW,CADC
• Barret Shaw, MD
• Shawna'S Help Desk LLC
• Kelsey Margaret Shay, LMSW
• Kayleigh Sheehan
• Robert Sheehan
• Georgia Sheena, PA-C

• Orthodontics and Dentofacial Orthopedics Dentistry in Southfield, MI
• Providers in Southfield, MI by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2020; 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.