DR. MICHAEL SHANE WALL D.M.D.
NPI 1396842589
Dentist - Orthodontics and Dentofacial Orthopedics in Statesboro, GA

Active since September 20, 2006
506 GENTILLY ROAD, STATESBORO, GA 30458(912) 764-6737(912) 489-4848 Get Directions Write a Review

NPPES record last updated: December 14, 2009. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Michael Shane Wall D.m.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MICHAEL SHANE WALL D.M.D. (NPI 1396842589) is an individual orthodontics and dentofacial orthopedics provider in Statesboro, Georgia, licensed in Georgia (DN012729) and active in the NPI registry since September 2006.

NPPES Registry Identity

NPI1396842589
Entity TypeIndividualMale
Primary Taxonomy1223X0400X
Provider Legal NameDR. MICHAEL SHANE WALLCredential: D.M.D.
Location Address506 GENTILLY ROADStatesboro, GA 30458
Mailing Address506 Gentilly RoadStatesboro, GA 30458 · (912) 764-6737 · Fax (912) 489-4848
Fax(912) 489-4848
Sole ProprietorNo
Enumeration DateSeptember 20, 2006
Last NPPES UpdateDecember 14, 2009
NPI 1396842589 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · Orthodontics and Dentofacial OrthopedicsDental Providers
Taxonomy Code1223X0400X
License Licensed in GA · DN012729
Definition
That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures.
506 GENTILLY ROAD, Statesboro, GA 30458

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Michael Wall's NPI number?

The NPI number for Michael Wall is 1396842589. It was assigned to this individual provider in the NPPES registry on September 20, 2006.

Where is Michael Wall located?

Michael Wall practices at 506 Gentilly Road, Statesboro, GA 30458. The listed phone number is (912) 764-6737.

What is Michael Wall's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Orthodontics and Dentofacial Orthopedics, with taxonomy code 1223X0400X.

When was this NPI record last updated?

The NPPES record for Michael Wall was last updated on December 14, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.