Shelly Self is a Pediatric Dentistry in Poulsbo, Washington. Shelly Self practices all healthcare services and medical treatments related to Pediatric Dentistry. The NPI Number for Shelly Self is 1336280957. The last update date is 2014-05-20.
Shelly Self's current location address is 19365 7th Ave Ne, Poulsbo, Washington. You can contact this provider via phone number 3607797115 and fax number 3607793990. The mailing address for Shelly Self is 19365 7th Ave Ne, Poulsbo, Washington. To know further, please read the information below!
Provider Profile Detail
Provider Name | Shelly Self |
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Address | 19365 7th Ave Ne, Poulsbo, Washington |
Phone Number | 3607797115 |
Fax Number | 3607793990 |
Sole Proprietor | Y |
Credentials | DMD |
NPI Number Detail
NPI Number | 1336280957 |
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Provider Enumeration Date | 2007-02-08 |
Last Updated Date | 2014-05-20 |
Provider Mailing Address Detail
Address | 19365 7th Ave Ne |
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City | Poulsbo |
State | Washington (WA) |
Post Code | 983707441 |
Phone Number | 3607797115 |
Fax Number | 3607793990 |
Provider's Primary Taxonomy Detail
Speciality | Pediatric Dentistry |
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Taxonomy | 1223P0221X |
Licence No | DE10256 |
Definition: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
Provider's Other Legacy Identifiers
Identifier | Identifier Type | Identifier State | Identifier Issuer |
---|---|---|---|
2035573 | WA | -- | |
1008098 | WA | -- |
Post Comment/ Review Below
What is the unique provider identifier assigned to Shelly Self?
The Shelly Self has been issued the NPI (National Provider Identifier) 1336280957 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you provide the complete address where Shelly Self is physically located?
The Shelly Self is situated at the following address: 19365 7Th Ave Ne, Poulsbo, WA 983707441.
What is Shelly Self's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Shelly Self is Pediatric Dentistry, and the corresponding taxonomy classification code for this specialized field is 1223P0221X.
When did Shelly Self receive its 1336280957 assignment?
The Shelly Self was assigned its 1336280957 on 2007-02-08, which is the date when this unique identifier was issued to the organization.
As of what date were the details pertaining to Shelly Self last refreshed?
The information related to the Shelly Self, including its address, specialty, and other relevant details, was last updated on 2014-05-20.
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