Provider Demographics
NPI:1245311026
Name:SHEHATA, ANDREW PAUL (DMD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:PAUL
Last Name:SHEHATA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1866 CANMONT DR NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30319-3618
Mailing Address - Country:US
Mailing Address - Phone:404-488-8111
Mailing Address - Fax:
Practice Address - Street 1:207 UPPER RIVERDALE RD SW
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:GA
Practice Address - Zip Code:30274-2537
Practice Address - Country:US
Practice Address - Phone:770-751-8887
Practice Address - Fax:770-692-0142
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0133121223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry