DANTE SANDLIN SHAW (PH.D.) – Clinical Psychologist, NPI 1841366630

DANTE SANDLIN SHAW (PH.D.) is a healthcare provider. based in Suwanee, Georgia. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PH.D.. They hold a License No. 0001314 (GA). The NPI Number for DANTE SANDLIN SHAW (PH.D.) is 1841366630

Main info

Male
Sole Proprietor
38 Years Of Experience
Accepts Medicare Assignment
Name
DANTE SANDLIN SHAW (PH.D.)
NPI
1841366630
Phone
(404) 556-4226
Address
2120 LAUREL LAKE DR
Enumeration Date
26 November 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4045564226
Graduation Year
1988 (38 years ago)
PAC ID
2466554746
Professional Enrollment ID
I20070219000072
Address ID
GA300468459LA750XXDXXX400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

482 CLINICAL PSYCHOLOGIST in GA

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Provider Addresses for DANTE SANDLIN SHAW (PH.D.)

  • 2120 LAUREL LAKE DR

    SUWANEE, GA 300244317

    Phone: (404) 556-4226

    Fax: (770) 963-7490

    Type: Mailing

  • 750, Longleaf Boulevard, Lawrenceville, Gwinnett County, Georgia, 30046, United States

    SUITE D

    LAWRENCEVILLE, GA 300458459

    Phone: (404) 556-4226

    Fax: (770) 963-7490

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2007-02-19

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20070219000072IClinical PsychologistGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30024)

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Reviews

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Frequently asked questions

Is there an official ID for DANTE SANDLIN SHAW (PH.D.) in U.S. healthcare records?
The official identifier for DANTE SANDLIN SHAW (PH.D.) is NPI 1841366630.
Is DANTE SANDLIN SHAW (PH.D.) shown as active in public data?
Registry records indicate DANTE SANDLIN SHAW (PH.D.) maintains an active NPI.
What expertise is attributed to DANTE SANDLIN SHAW (PH.D.)?
DANTE SANDLIN SHAW (PH.D.)'s specialty line reads Clinical Psychologist. Clinical services aligned with this taxonomy classification.
Where in Georgia is DANTE SANDLIN SHAW (PH.D.) registered?
Use Suwanee, Georgia as the headline location for DANTE SANDLIN SHAW (PH.D.) here.
Does DANTE SANDLIN SHAW (PH.D.) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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