Provider Demographics
NPI:1336158559
Name:SHAW, DAWN ANNMARIE (DDS)
Entity type:Individual
Prefix:DR
First Name:DAWN
Middle Name:ANNMARIE
Last Name:SHAW
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 1:9701 POLING TER
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-3970
Mailing Address - Country:US
Mailing Address - Phone:301-265-1176
Mailing Address - Fax:240-607-6620
Practice Address - Street 1:6827 ANNAPOLIS RD
Practice Address - Street 2:
Practice Address - City:LANDOVER HILLS
Practice Address - State:MD
Practice Address - Zip Code:20784-2000
Practice Address - Country:US
Practice Address - Phone:301-773-7588
Practice Address - Fax:301-773-7559
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD114651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice