Provider Demographics
NPI:1467837641
Name:MEYER, SHAINA (DDS, MA CCC-SLP)
Entity Type:Individual
Prefix:DR
First Name:SHAINA
Middle Name:
Last Name:MEYER
Suffix:
Gender:F
Credentials:DDS, MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 GRACELAND BLVD # 214
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-1530
Mailing Address - Country:US
Mailing Address - Phone:614-206-1495
Mailing Address - Fax:
Practice Address - Street 1:6441 WINCHESTER BLVD
Practice Address - Street 2:
Practice Address - City:CANAL WINCHESTER
Practice Address - State:OH
Practice Address - Zip Code:43110-2033
Practice Address - Country:US
Practice Address - Phone:614-834-3455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-29
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOND.2015286-SP235Z00000X
OH30.0271541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist