Provider Demographics
NPI:1477700482
Name:SHAW, JOI D'ANTOINETTE (DMD, MSD)
Entity Type:Individual
Prefix:DR
First Name:JOI
Middle Name:D'ANTOINETTE
Last Name:SHAW
Suffix:
Gender:F
Credentials:DMD, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3939 WASHINGTON AVE
Mailing Address - Street 2:SUITE 240
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-5603
Mailing Address - Country:US
Mailing Address - Phone:713-863-7336
Mailing Address - Fax:713-863-7606
Practice Address - Street 1:3939 WASHINGTON AVE
Practice Address - Street 2:SUITE 240
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-5603
Practice Address - Country:US
Practice Address - Phone:713-863-7336
Practice Address - Fax:713-863-7606
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-20
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX237581223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry