Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1013171438 Individual Practitioner Female Practitioner

Dr. Shaletha M Bolden , DDS, MSD

Dentist - Endodontics • Canton, GA

Professional Overview & Biography Verified Profile Summary

Dr. Shaletha Bolden, DDS, MSD is a registered healthcare professional specializing in Dentist - Endodontics in Canton, GA. Practice services are available at 1425 RIVERSTONE PKWY STE 200 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1425 Riverstone Pkwy Ste 200

Canton, GA 301145611

Telephone 7704790600
Associated Practice Facility / Clinic
🏢 Canton Smiles Dentistry, Pc Facility NPI 1093149486

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - Endodontics in Canton, GA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
1 Specialists

Practicing in Canton, GA (162 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - Endodontics Primary Specialty

NUCC Taxonomy Code: 1223E0200X

State License GA DN015429

The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions.

Dentist - Endodontics

NUCC Taxonomy Code: 1223E0200X

State License TX 27790

The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions.

Dentist - Endodontics

NUCC Taxonomy Code: 1223E0200X

State License TN 8802

The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners
Dr. Niang Muang , DMD

Dentist - General Practice

NPI 1154216216

Doctor of Dental Medicine

Dr. Jongbin Wie , DMD

Dentist - General Practice

NPI 1164101945

Doctor of Dental Medicine

NPI 1215442017

Doctor of Dental Medicine

Dr. Megan Davidson , DMD

Dentist - General Practice

NPI 1346841624

Doctor of Dental Medicine

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

12 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 21, 2022

Dentist (License #27790 in TX)

NPI Profile Active September 08, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location September 08, 2017

Registered at 1425 RIVERSTONE PKWY STE 200, CANTON, GA 301145611 (Tel: 7704790600)

📍
Updated Business Mailing Address September 08, 2017

Registered at 1425 RIVERSTONE PKWY, SUITE 200, CANTON, GA 30114 (Tel: (770) 479-0600)

👤
Provider Name / Credentials Updated September 08, 2017

Recorded as SHALETHA BOLDEN, DDS, MSD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 08, 2017

Dentist (License #DN015429 in GA)

NPI Profile Active July 16, 2012

NPI status registered as active in NPPES database

📍
Updated Practice Location July 16, 2012

Registered at 6628 LAKE WORTH BLVD, SUITE 200, LAKE WORTH, TX 761353018 (Tel: 8172387984)

📍
Updated Business Mailing Address July 16, 2012

Registered at 6628 LAKE WORTH BLVD, SUITE 200, LAKE WORTH, TX 761353018 (Tel: 8172387984)

👤
Provider Name / Credentials Updated July 16, 2012

Recorded as SHALETHA BOLDEN, DDS, MSD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 16, 2012

Dentist (License #27790 in TX)

🟢
Initial NPI Registration & Enumeration July 15, 2008

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1013171438
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 15, 2008
Last Update: July 21, 2022
Sole Proprietor: Yes

Mailing Address

1425 Riverstone Pkwy, Suite 200

Canton, GA 30114

Phone: 7704790600

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.