MEDICARE: SHAHSAWER, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223D0001X	Public Health Dentistry

General Provider Information

NPI Number	:	1568314417
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHAHSAWER, LLC

Provider Business Mailing Address
First Line	:	4715 E 91ST ST STE 110
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74137-2847
Country	:	US
Telephone Number	:	918-574-1400
Fax Number	:

Provider Business Practice Location Address
First Line	:	4715 E 91ST ST STE 110
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74137-2847
Country	:	US
Telephone Number	:	918-574-1400
Fax Number	:

Authorized Official
Title or Position	:	HUMAN RESOURCES
Name	:	SHAYLA MOORE
Credential	:
Telephone Number	:	402-505-6843

Provider Enumeration Date	:	02/12/2026
Last Update Date	:	02/12/2026

Similar Medicare Providers

1073447041 — DYER PALM LEAF DENTAL LLC
Practice Location Address:

4715 E 91ST ST STE 110
TULSA, OK
74137-2847

Practice Phone: 833-923-4468
Practice Fax:

1689509986 — AMANI ABU-IRMAILEH
Practice Location Address:

8102 S YALE AVE
TULSA, OK
74137-2210

Practice Phone: 918-477-7882
Practice Fax:

1710471917 — KATHRYN SALAMANDRA PT
Practice Location Address:

2488 E 81ST ST STE 290
TULSA, OK
74137-4265

Practice Phone: 918-494-2665
Practice Fax: 918-927-3201

1003175704 — TODD J SMETANA LPC
Practice Location Address:

6226 E 101ST ST STE 150
TULSA, OK
74137-7124

Practice Phone: 918-400-9144
Practice Fax:

1184589269 — JESURUN SHELTON
Practice Location Address:

2448 E 81ST ST STE 4460
TULSA, OK
74137-4251

Practice Phone: 918-600-2966
Practice Fax:

1033503073 — ERIC HYDE
Practice Location Address:

8810 S YALE AVE STE F
TULSA, OK
74137-3551

Practice Phone: 918-513-1351
Practice Fax:

Directions to “SHAHSAWER, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.