Selleck DDS Inc a Professional Dental Corporation

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

24502 Issued in CA

Legal business name

SELLECK DDS INC A PROFESSIONAL DENTAL CORPORATION

Doing business as

DENTAL SLEEP MEDICINE OFFICES OF MICHAEL J. SELLECK

Practice address

935 Moraga Rd
Suite #101
Lafayette, CA 94549-4584

Phone

(925) 283-0338

NPI assigned

Mar 11, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Michael J Selleck, DDS

Title

Owner/Clinician

Phone

(925) 383-0338

Specialties & licenses 1

Addresses

Other names 1

• DENTAL SLEEP MEDICINE OFFICES OF MICHAEL J. SELLECK Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1362960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362960000000",
    "number": "1053652420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "935 MORAGA RD",
            "address_2": "SUITE #101",
            "city": "LAFAYETTE",
            "state": "CA",
            "postal_code": "945494584",
            "telephone_number": "925-283-0338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "935 MORAGA RD",
            "address_2": "SUITE #101",
            "city": "LAFAYETTE",
            "state": "CA",
            "postal_code": "945494584",
            "telephone_number": "925-283-0338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELLECK DDS INC A PROFESSIONAL DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-11",
        "last_updated": "2013-03-11",
        "status": "A",
        "authorized_official_last_name": "SELLECK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER/CLINICIAN",
        "authorized_official_telephone_number": "925-383-0338",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "24502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DENTAL SLEEP MEDICINE OFFICES OF MICHAEL J. SELLECK",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Emily Johanna Schuman, BCBA
• Sarah Schutzberger, RD, CSO
• Deborah Schwing, LMFT, LPCC
• Franisha L Scurlock
• Jocelyn Segoviano
• Michael James Selleck, D.D.S.
• Eriza Serrano Siordia
• Manaal Shaad
• Satinder Kaur Sheena, RPH
• Deb Shell, AMFT

• Durable Medical Equipment & Medical Supplies in Lafayette, CA
• Providers in Lafayette, CA by specialty
• Durable Medical Equipment & Medical Supplies in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.