Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1366591166 Individual Practitioner Male Practitioner

Dr. Thomas Edward Shaw , DDS

Dentist - General Practice • Kennesaw, GA

Professional Overview & Biography Verified Profile Summary

Dr. Thomas Shaw, DDS is a registered healthcare professional specializing in Dentist - General Practice in Kennesaw, GA. Practice services are available at 2750 WATTS DR NW under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

2750 Watts Dr Nw

Kennesaw, GA 301442721

Telephone 7704290955
Fax 7704290219
Associated Practice Facility / Clinic
🏢 Dental Excellence Of Kennesaw Facility NPI 1710048848

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Kennesaw, GA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 22.8 Yrs
Regional Practice Density
41 Specialists

Practicing in Kennesaw, GA (3302 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: 2023-03-23
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License GA DN009589

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.

Dentist - General Practice

NUCC Taxonomy Code: 1223G0001X

State License FL DN9316

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.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
003155301A (GA)
Medicaid State Provider ID
004102800 (FL)

Practice Associates & Co-Workers

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

2 Associated Practitioners
Dr. Lisa Kirshenbaum , DMD

Dentist - General Practice

NPI 1114142171

Doctor of Dental Medicine

Dr. James Smith , DDS

Dentist - General Practice

NPI 1912122961

Doctor of Dental Surgery

Career & Practice History Timeline

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

14 Historical Events
📍
Updated Practice Location March 23, 2023

Registered at 2750 WATTS DR NW, KENNESAW, GA 301442721 (Tel: 7704290955)

📍
Updated Practice Location October 07, 2022

Registered at 3329 COBB PKWY NW STE 300, ACWORTH, GA 301018841 (Tel: 7705759960)

📍
Updated Practice Location December 14, 2021

Registered at 100 COURTYARD DR SE, CARTERSVILLE, GA 301208523 (Tel: 7703825678)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 14, 2021

Dentist (License #DN9316 in FL)

📍
Updated Practice Location January 13, 2020

Registered at GREAT EXPRESSIONS-SUMMIT, 3823 ROSWELL RD STE. 205, MARIETTA, GA 30062 (Tel: 7709739265)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 13, 2020

Dentist (License #DN009589 in GA)

📍
Updated Practice Location June 03, 2018

Registered at 109 EAST AVE, CEDARTOWN, GA 30125 (Tel: 7707487736)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 03, 2018

Dentist (License #DN9316 in FL)

NPI Profile Active January 02, 2015

NPI status registered as active in NPPES database

📍
Updated Practice Location January 02, 2015

Registered at 16 E 12TH ST SW, ROME, GA 301614720 (Tel: 7068025050)

📍
Updated Business Mailing Address January 02, 2015

Registered at 371 HICKORY LAKE DR, ACWORTH, GA 301018753 (Tel: 8636602316)

👤
Provider Name / Credentials Updated January 02, 2015

Recorded as THOMAS SHAW, D.D.S.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 02, 2015

Dentist (License #DN009589 in GA)

🟢
Initial NPI Registration & Enumeration January 09, 2007

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: 1366591166
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 09, 2007
Last Update: March 23, 2023
Sole Proprietor: No

Mailing Address

371 Hickory Lake Dr

Acworth, GA 301018753

Phone: 8636602316

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.