NPI age
19 years
Enumerated 2006-09-20
● Active
Type 1 · Individual
DR. Michael Shane Wall, D.M.D.
Wall is 1 of 2 dentist providers in Statesboro and 1 of 526 in Georgia.
Primary specialty
Dentist
Licensed in
GA
1 state
Status
Active
No deactivations on record
Last NPPES update
2009-12-14
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 526 active dentist providers in Georgia.
NPI age
19 years
↑ 2 yr above median (17 yr)
State licenses
1 state
9% of peers hold multiple states
Subspecialties
0
16% of peers hold subspecialties
NPI lifetime · 2006 → 2026
2006-09Enumerated in NPPES
2006
2026
Where they practice
Practice location
506 Gentilly Road
Statesboro, GA 30458
Mailing address
506 Gentilly Road
Statesboro, GA 30458
Specialties
-
Dentist PrimaryThat 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...
Practice context
Solo or small practice. No other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.