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General NPI Number Information
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NPI Number | 1760571103
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Entity Type | Individual
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Provider Name | SHAWN ALLEN MAY DDS
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Gender | Male
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 06/02/2022
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Provider Practice Location Address
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Address Line | 6407 N ILLINOIS ST
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City | FAIRVIEW HEIGHTS
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State | IL
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Zip | 62208-2720
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Country | US
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Telephone | 618-310-0263
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Fax | 618-212-9054
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Provider Business Mailing Address
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Address Line | 209 WILLIAMSBURG DR
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City | CRYSTAL CITY
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State | MO
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Zip | 63019-1271
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Country | US
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Telephone | 217-450-7535
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Fax | 618-212-9054
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 019027153
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2018028936
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License Number State | MO
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