DR. SHANE ANTHONY WILLIAMS (NPI# 1437315272) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437315272 |
| Entity Type | Individual |
| Full Name | DR. SHANE ANTHONY WILLIAMS |
| Credential | D.M.D. |
| Practice Address |
1938 Lyda Ave Bowling Green KY 42104-3326 |
| Mailing Address |
1938 Lyda Avenue Bowling Green KY 42104 |
| Practice Telephone | (270) 783-0064 |
| Practice Fax Number | 2709011997 |
| Mailing Telephone | 2707830064 |
| Mailing Fax Number | 2709011997 |
| Enumeration Date | 2008-07-31 |
| Last Update Date | 2020-08-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223P0106X |
Dentist Specialization: Oral and Maxillofacial Pathology |
9943 | KY | Dental Providers |
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
9943 | KY | Dental Providers |
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
9422 | TN | Dental Providers |
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
332 | OK | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 1528342 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2400 Patterson Street, Suite 316, Nashville, TN 372036510 | 6153273534 | 6153273552 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881797660 | Shane Manson Williams | Chiropractor | 319 Abc Unit A, Aspen, CO 81611-3516 | 2006-09-06 |
| 1073157608 | Shane Williams | Occupational Therapist | 535 Flushing Ave, Brooklyn, NY 11205-1610 | 2019-11-06 |
| 1932760766 | Shane Williams | Massage Therapist | 109 Lynch St, Ste B, Wrangell, AK 99929 | 2019-06-24 |
| 1871099309 | Shane Michael Williams | Family Medicine | 375 S Chipeta Way Ste A, Salt Lake City, UT 84108-1261 | 2018-04-03 |
| 1346629037 | Shane Williams | Family Medicine | 2001 W 68th St Ste 202, Hialeah, FL 33016-1801 | 2015-05-27 |
| 1952681421 | Shane Williams | Pharmacist | 121 Se 6th Ave, Topeka, KS 66603-3516 | 2011-08-27 |
| 1972690279 | Shane K Williams | Orthopaedic Surgery | 11406 Loma Linda Dr, Loma Linda, CA 92354-3711 | 2006-10-06 |
| Street Address |
1938 LYDA AVE |
| City | BOWLING GREEN |
| State | KY |
| Zip Code | 42104-3326 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649261850 | Jeffrey M Clark | Dentist | 1938 Lyda Ave, Bowling Green, KY 42104-3326 | 2005-11-04 |
| 1083971956 | Samantha Jo Johnson | Dentist | 1938 Lyda Ave, Bowling Green, KY 42104-3326 | 2012-04-17 |
| 1013104892 | Southern Kentucky Oral Surgery Associates Pllc | Dentist | 1938 Lyda Ave, Bowling Green, KY 42104-3326 | 2007-09-26 |
| 1891843504 | Jerry E Cohron | Dentist | 1938 Lyda Ave, Bowling Green, KY 42104-3326 | 2007-01-08 |
| 1164527420 | Tony Brandon Greer | Dentist | 1938 Lyda Ave, Bowling Green, KY 42104-3326 | 2006-09-13 |
| 1316916463 | James Michael Sutton | Dentist | 1938 Lyda Ave, Bowling Green, KY 42104-3326 | 2006-03-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043822042 | Ashley Marie Sterchi | Speech-Language Pathologist | The Kid Spot Center, 944 Fields Dr. #102, Bowling Green, KY 42104 | 2020-08-20 |
| 1093339111 | Rachel Marie Held | Specialist/Technologist | 886c Lynnwood Way, Apt. #7, Bowling Green, KY 42104 | 2020-06-04 |
| 1043846769 | C D S 10 Pharmacy LLC | Pharmacy | 1308 Ashley Circle, Bowling Green, KY 42104 | 2020-03-13 |
| 1073075792 | Applegate Health Services, Inc | Clinic/Center | 5966 Scottsville Road Unit 7, Bowling Green, KY 42104 | 2019-04-02 |
| 1487122099 | Candice Spencer | Specialist/Technologist, Other | 1945 Scottsville Rd B2 Pmb 397, Bowling Green, KY 42104 | 2018-11-13 |
| 1053819904 | Cumberland Foot and Ankle Centers | Orthopaedic Surgery | 1850 Westen Street, Bowling Green, KY 42104 | 2018-01-25 |
| 1841731494 | Olivia Catherine Sanders | Speech-Language Pathologist | 954 Aristides Dr, Bowling Green, KY 42104 | 2017-03-15 |
| 1376901488 | Trung Trinh | Pharmacist | 1530 Campbell Lane, Bowling Green, KY 42104 | 2016-02-03 |
| 1225409121 | Adam Wesley Baird | Optometrist | 760 Campbell Lane, Suite 120, Bowling Green, KY 42104 | 2015-10-18 |
| 1851797898 | Michelle Leigh King | Speech-Language Pathologist | 829 Mandarin Ave., Bowling Green, KY 42104 | 2014-11-18 |
| Find all providers in zip 42104 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477707784 | Nuckols & Cohron, P.s.c. | Dentist | 627 Eastwood St, Bowling Green, KY 42103-1688 | 2008-11-13 |
| 1134283765 | Mark S Allen | Dentist | 1716 Ashley Cir, Bowling Green, KY 42104-3366 | 2006-12-20 |
| 1679676191 | Edyee Mullins Sturgill | Dentist | 895 Wilkinson Trce Ste B, Bowling Green, KY 42103-2486 | 2006-09-07 |
| 1245244474 | Charles Thomas Nuckols | Dentist | 627 Eastwood Ave, Bowling Green, KY 42103-1688 | 2006-07-27 |
| 1841282027 | Brian M O'neill | Dentist | 970 W Wooster St, Ste 126, Bowling Green, OH 43402-2643 | 2005-08-16 |
| 1164527420 | Tony Brandon Greer | Dentist | 1938 Lyda Ave, Bowling Green, KY 42104-3326 | 2006-09-13 |
| 1982696175 | Oral & Maxillofacial Surgeons Inc | Dentist | 970 W Wooster St, Suite 126, Bowling Green, OH 43402-2643 | 2005-08-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942705728 | Karah Lee Ellen Brown | Dentist | 800 Rose Street, Room D-508, Lexington, KY 40536 | 2018-03-26 |
| 1023510518 | Ralph M. Green Medical Pllc | Dentist | 3809 Poplar Level Rd Ste B, Louisville, KY 40213-1429 | 2018-03-01 |
| 1982058590 | Heine, Heine and Bowles, Pllc | Dentist | 2850 Lone Oak Rd Ste 5, Paducah, KY 42003-8043 | 2016-04-20 |
| 1326400789 | Corey Alan Taylor | Dentist | 800 Rose St # D-538, Lexington, KY 40536-7001 | 2016-03-24 |
| 1689060808 | Brandyn Herman | Dentist | Uk Dentistry At Turfland, 2195 Harrodsburg Rd, Ste 175, Lexington, KY 40536 | 2015-04-14 |
| 1619243268 | William J Curtis | Dentist | 800 Rose St Rm D508, University of Kentucky College of Dentistry, Lexington, KY 40536-0297 | 2012-03-28 |
| 1558651554 | Robbie James Harris IIi | Dentist | 4975 Alben Barkley Dr Ste 4, Paducah, KY 42001-6722 | 2011-04-11 |
| 1053541219 | Andrew William Ray | Dentist | 2421 Gooseberry Cir, Lexington, KY 40509-8567 | 2009-07-22 |
| 1407096639 | Charles William Langford Jr. | Dentist | 445 Stableford Cir, Owensboro, KY 42303-7771 | 2009-02-27 |
| 1245481175 | Joseph H. Cieslak Dds, Pllc | Dentist | 6501 Dixie Hwy, Louisville, KY 40258-3907 | 2008-10-09 |
| Find all providers with the same taxonomy | ||||
| City | BOWLING GREEN |
| Zip Code | 42104 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.