Shawn Alan Walls, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

010715 Issued in GA

Practice address

10700 Medlock Bridge Rd
Suite 202
Johns Creek, GA 30097-8456

Phone

(770) 813-0079

Fax

(770) 814-7407

NPI assigned

Apr 11, 2007

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Shawn a. Walls, DDS, PC

  • General Practice Dentistry
  • Johns Creek, GA
  • NPI 1093411910
  NPD Authorized official
• Shawn a. Walls, DDS, PC

  • General Practice Dentistry
  • Johns Creek, GA
  • NPI 1376929125
  NPD Authorized official

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305072000000",
    "number": "1952524316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10700 MEDLOCK BRIDGE RD",
            "address_2": "SUITE 202",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300978456",
            "telephone_number": "770-813-0079",
            "fax_number": "770-814-7407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10700 MEDLOCK BRIDGE RD",
            "address_2": "SUITE 202",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300978456",
            "telephone_number": "770-813-0079",
            "fax_number": "770-814-7407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLS",
        "first_name": "SHAWN",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-11",
        "last_updated": "2011-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "010715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Carl Waldrop, M.D.
• Walgreen Co (Walgreens #05903)
• Kathleen W Walker-Amadasun, RN MSN
• Jazmine Walker
• Tequila Walker, CNA
• Stephen Walters, APC, NCC
• Yanzhen Wang, MASSAGE THERAPIST
• Taylor Rae Warren, ED.S., LPC
• Craig Shannon Waters
• Waypoint Therapy Solutions

• General Practice Dentistry in Johns Creek, GA
• Providers in Johns Creek, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2011; 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.