IndividualActive
Michael Shaw, DDS
NPI 1679594113 · Oral and Maxillofacial Pathology Dentistry · Modesto, CA
Provider details
- NPI number
- 1679594113
- Entity type
- Individual
- Primary specialty
- Oral and Maxillofacial Pathology DentistryDental Providers
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- No
- License
- DW035996 (CA)
Specialties & taxonomies
Dental Providers
Practice location
2020 Standiford Ave Ste B
Modesto, CA 95350-6530
Phone: (209) 525-9339
Fax: (209) 525-9366
Approximate (ZIP-level) locationGet directions
Mailing address
222 Memory Ln
Turlock, CA 95382-7272
Registry dates
- Enumerated
- 2006-07-21
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.