Jerry L. Shaw, D.D.S.

LBN: Jerry L. Shaw, D.D.S.
Jerry L. Shaw, D.D.S. is an health care organization with primary practice located at 1761 N. 2000 W. , Farr West UT 84404-9541. The organization recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as the primary health care specialty. Jerry L. Shaw, D.D.S. can be contacted via phone (801) 731-4850, or through Shaw, Jerry L. via phone (801) 731-4850.

Contact Information

Primary practice address
1761 N. 2000 W. Farr West UT 84404-9541
Fax: (801) 731-4852
Website:
Authorized official contact:
Name: Shaw, Jerry L. Doctor of Dental Surgery (DDS)

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X 132357 Utah

Profile Details

NPI number 1205111432
LBN Legal business name Jerry L. Shaw, D.D.S.
DBA Doing business as
Authorized official Shaw, Jerry L. Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 19th, 2011
Last updated Oct 19th, 2011 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1205111432 NPPES
Utah MEDICAID 529447754018

Popular Providers