Provider Demographics
NPI:1669727558
Name:NEMOVI, SHAWN (DDS)
Entity type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:
Last Name:NEMOVI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:SHAWN
Other - Middle Name:
Other - Last Name:NEMOVI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:4704 WINDRUSH CIR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-3955
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2306 GREENCREST BLVD
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087-5513
Practice Address - Country:US
Practice Address - Phone:469-338-4518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-17
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX28204122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist