Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1083176275 Individual Practitioner Female Practitioner

Dr. Keyanni Jhamia Shaw , DDS

Dentist • Douglasville, GA

Professional Overview & Biography Verified Profile Summary

Dr. Keyanni Shaw, DDS is a registered healthcare professional specializing in Dentist in Douglasville, GA. Practice services are available at 6351 DOUGLAS BLVD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

6351 Douglas Blvd

Douglasville, GA 301357102

Telephone 4042670400
Associated Practice Facility / Clinic
🏢 Love Your Smile Llc Facility NPI 1578001384

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Douglasville, GA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 26.3 Yrs
Regional Practice Density
16 Specialists

Practicing in Douglasville, GA (2164 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

CMS Verified: 2021-07-22
Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License GA DN122281

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Dentist - General Practice

NUCC Taxonomy Code: 1223G0001X

State License SC DGD.9664

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Practice Associates & Co-Workers

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

2 Associated Practitioners
NPI 1518123439

Doctor of Dental Surgery

Dr. Rhoda-Leann Norris , DMD

Dentist - General Practice

NPI 1629485164

Doctor of Dental Medicine

Career & Practice History Timeline

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

11 Historical Events
📍
Updated Practice Location July 22, 2021

Registered at 6351 DOUGLAS BLVD, DOUGLASVILLE, GA 301357102 (Tel: 4042670400)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 22, 2021

Dentist (License #DN122281 in GA)

📍
Updated Practice Location July 30, 2020

Registered at 2235 W DEKALB ST, CAMDEN, SC 290202169 (Tel: 4045236571)

📍
Updated Business Mailing Address July 30, 2020

Registered at 11409 PANHANDLE RD, HAMPTON, GA 302281504 (Tel: 7705724915)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 30, 2020

Dentist (License #DGD.9664 in SC)

NPI Profile Active April 05, 2019

NPI status registered as active in NPPES database

📍
Updated Practice Location April 05, 2019

Registered at 1015 DONALD LEE HOLLOWELL PKWY NW, ATLANTA, GA 303186653 (Tel: 4045236571)

📍
Updated Business Mailing Address April 05, 2019

Registered at 26480 BERG RD APT 1213, SOUTHFIELD, MI 480338615 (Tel: 7705724915)

👤
Provider Name / Credentials Updated April 05, 2019

Recorded as KEYANNI SHAW, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 05, 2019

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration April 05, 2019

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1083176275
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 05, 2019
Last Update: July 22, 2021
Sole Proprietor: Yes

Mailing Address

11409 Panhandle Rd

Hampton, GA 302281504

Phone: 7705724915

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.