Healthcare Provider Details

I. General information

NPI: 1417748344
Provider Name (Legal Business Name): SHAMIRA T MALEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2025
Last Update Date: 05/12/2025
Certification Date: 05/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9144 CINCINNATI COLUMBUS RD
WEST CHESTER OH
45069-3702
US

IV. Provider business mailing address

8185 BLANCHETTA DR
CINCINNATI OH
45239-4554
US

V. Phone/Fax

Practice location:
  • Phone: 513-777-6444
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number31.016215
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: