Provider Demographics
NPI:1255015731
Name:HOWARD, SHANA DANAE (DDS)
Entity type:Individual
Prefix:DR
First Name:SHANA
Middle Name:DANAE
Last Name:HOWARD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 SE DOVETAIL RD
Mailing Address - Street 2:
Mailing Address - City:GRIMES
Mailing Address - State:IA
Mailing Address - Zip Code:50111-4749
Mailing Address - Country:US
Mailing Address - Phone:515-447-3893
Mailing Address - Fax:
Practice Address - Street 1:1541 SE 3RD ST STE 300
Practice Address - Street 2:
Practice Address - City:GRIMES
Practice Address - State:IA
Practice Address - Zip Code:50111-8878
Practice Address - Country:US
Practice Address - Phone:515-986-4001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IADDS-101191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice