Provider Demographics
NPI:1689817058
Name:SHAIA, ANTHONY A (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:A
Last Name:SHAIA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6500 PEARL RD
Mailing Address - Street 2:SUITE #100
Mailing Address - City:PARMA HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-3813
Mailing Address - Country:US
Mailing Address - Phone:440-884-9898
Mailing Address - Fax:440-884-9030
Practice Address - Street 1:6500 PEARL RD
Practice Address - Street 2:SUITE #100
Practice Address - City:PARMA HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-3813
Practice Address - Country:US
Practice Address - Phone:440-884-9898
Practice Address - Fax:440-884-9030
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-14
Last Update Date:2013-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300212621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice