Provider Demographics
NPI:1972348084
Name:BRYSON-MCAULEY, SHAMIKA SHANTA (DDS)
Entity type:Individual
Prefix:DR
First Name:SHAMIKA
Middle Name:SHANTA
Last Name:BRYSON-MCAULEY
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 1:753 OWENS CV
Mailing Address - Street 2:
Mailing Address - City:COLLIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38017-3517
Mailing Address - Country:US
Mailing Address - Phone:901-634-4567
Mailing Address - Fax:
Practice Address - Street 1:3030 COVINGTON PIKE STE 150
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38128-5041
Practice Address - Country:US
Practice Address - Phone:901-310-1441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-28
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12586122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist