IndividualActive
Shineille Blair, DDS
NPI 1073290185 · Dentist · Fayetteville, GA
Provider details
- NPI number
- 1073290185
- Entity type
- Individual
- Primary specialty
- DentistDental Providers
- Credential
- DDS
- Sex
- Female
- Sole proprietor
- No
- License
- DN123140 (GA)
Specialties & taxonomies
Dental Providers
Profile Score
Established profile(67/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
6 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
719 Lanier Ave W
Fayetteville, GA 30214-7634
Phone: (770) 615-0999
Fax: (770) 731-2385
Street-level locationGet directions
Mailing address
14500 Sw 37th St
Miramar, FL 33027-3789
Additional practice locations (5)
- 3695 Cascade Rd Sw Ste VAtlanta, GA 30331-2146Phone: (404) 236-6024
- 3890 Redwine Rd Sw Ste 108Atlanta, GA 30331-5583Phone: (404) 586-4848
- 1607 White WayAtlanta, GA 30344-3317Phone: (404) 382-5845
- 6175 Old National Hwy Ste 430Atlanta, GA 30349-4470Phone: (678) 228-8235
- 3050 Martin Luther King Jr Dr SwAtlanta, GA 30311-1500Phone: (404) 696-3163
Registry dates
- Enumerated
- 2023-06-30
- Last updated
- 2023-06-30
- Certified
- 2023-06-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.