Active NPI
James S Shelby, D.D.S.
- General Practice Dentistry
- Spokane, WA
National Provider Identifier
1104912278
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(4) exclusion effective Dec 19, 2019.
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 7654
- Practice address
- 3233 W Indian Trail Rd
Spokane, WA 99208-4761 - Phone
- (509) 326-5454
- Fax
- (509) 326-0314
- NPI assigned
- Oct 5, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 7654 | WA | Primary |
Addresses
Primary practice location
3233 W Indian Trail Rd
Spokane, WA 99208-4761
Mailing address
3233 W Indian Trail Rd
Spokane, WA 99208-4761
Phone (509) 326-5454
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4025322 | Other | PA | UNITED CONCORDIA |
| 5025127 | Other | WA | DSHS |
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7654 | WA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| James S Shelby D.D.S | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Dental Clinic/Center
- Spokane, WA
- NPI 1518310655
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104912278",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3233 W INDIAN TRAIL RD",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992084761",
"telephone_number": "509-326-5454",
"fax_number": "509-326-0314"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3233 W INDIAN TRAIL RD",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992084761",
"telephone_number": "509-326-5454",
"fax_number": "509-326-0314"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHELBY",
"first_name": "JAMES",
"middle_name": "S",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WA",
"license": "7654",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA",
"identifier": "4025322",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DSHS",
"identifier": "5025127",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Spokane, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.