Provider Demographics
NPI:1508382565
Name:BILLICK-GERLING, SHAWNA M (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHAWNA
Middle Name:M
Last Name:BILLICK-GERLING
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21714 HARDY OAK BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4839
Mailing Address - Country:US
Mailing Address - Phone:1210-497-8787
Mailing Address - Fax:210-495-6866
Practice Address - Street 1:21714 HARDY OAK BLVD STE 102
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4839
Practice Address - Country:US
Practice Address - Phone:210-497-8787
Practice Address - Fax:210-495-6866
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-21
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX212041223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1346257276OtherLITTLE TEETH OF TEXAS PA