Scott Gallagher Shaw, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE 60035235 Issued in WA

Practice address

2704 171St PL NE
Marysville, WA 98271

Phone

(206) 769-0903

NPI assigned

May 15, 2009

Last updated

May 15, 2009By 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 WA

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": "1242345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242345600000",
    "number": "1992930226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3372 COLUMBUS LN",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481032788",
            "telephone_number": "206-769-0903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2704 171ST PL NE",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "98271",
            "telephone_number": "206-769-0903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "SCOTT",
        "middle_name": "GALLAGHER",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-05-15",
        "last_updated": "2009-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE 60035235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Lynn Sewares, LMP
• Tiffany Lee Shanks, LMP
• Sydney Shaphren, MCOUN, NCC
• Hannah Dereen Sharpe, RN
• Dan F Shaw, DMD
• Kassim Ibrahim Sheimo
• Triana B Sherwood, LMP
• Sophia Shiau, M.D.
• Teshome Shikesso, NP PSYCH/MENTAL HEAL
• Jessica Shin

• General Practice Dentistry in Marysville, WA
• Providers in Marysville, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2009; 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.