Active NPI
Grace Shelledy, DDS
- Dentist
- Beaufort, SC
National Provider Identifier
1063258507
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DEN.00206072
- Practice address
- 670 Boulevard de France, BLDG 674
MCRD Parris Island
Beaufort, SC 29902 - Phone
- (843) 228-4682
- NPI assigned
- Jul 3, 2024
- Last updated
- Sep 5, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DEN.00206072 | CO | Primary |
Addresses
Primary practice location
670 Boulevard de France, BLDG 674
MCRD Parris Island
Beaufort, SC 29902
Mailing address
MCRD Parris Island Dental
BLDG 674 Blvd de France
Parris Island, SC 29905
Phone (530) 219-7774
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DEN.00206072 | CO | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1719964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757030400000",
"number": "1063258507",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "MCRD PARRIS ISLAND DENTAL",
"address_2": "BLDG 674 BLVD DE FRANCE",
"city": "PARRIS ISLAND",
"state": "SC",
"postal_code": "29905",
"telephone_number": "530-219-7774"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "670 BOULEVARD DE FRANCE, BLDG 674",
"address_2": "MCRD PARRIS ISLAND",
"city": "BEAUFORT",
"state": "SC",
"postal_code": "29902",
"telephone_number": "843-228-4682"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHELLEDY",
"first_name": "GRACE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-07-03",
"last_updated": "2025-09-05",
"certification_date": "2025-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CO",
"license": "DEN.00206072",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beaufort, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.