Provider Demographics
NPI:1154195576
Name:MORGAN, SHAKAYLA (DDS)
Entity type:Individual
Prefix:DR
First Name:SHAKAYLA
Middle Name:
Last Name:MORGAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 EMILY ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01109-1013
Mailing Address - Country:US
Mailing Address - Phone:413-883-2276
Mailing Address - Fax:
Practice Address - Street 1:37 EMILY ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01109-1013
Practice Address - Country:US
Practice Address - Phone:413-883-2276
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-07
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18600561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice