Active NPI
Diana Sue Shelby, DPD
- Denturist
- Kennewick, WA
National Provider Identifier
1104933571
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Denturist
- License
- DN00000253
- Practice address
- 5219 West Clearwater Ave
Suite 8
Kennewick, WA 99336 - Phone
- (509) 374-1660
- Fax
- (509) 374-9374
- NPI assigned
- Aug 23, 2006
- 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 |
|---|---|---|---|---|
| Denturist | 122400000X | DN00000253 | WA | Primary |
Addresses
Primary practice location
5219 West Clearwater Ave
Suite 8
Kennewick, WA 99336
Mailing address
5219 West Clearwater Ave
Suite 8
Kennewick, WA 99336
Phone (509) 374-1660
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 15049275 | Medicaid | WA |
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 |
|---|---|---|---|
| DN00000253 | WA | MD | Denturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104933571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5219 WEST CLEARWATER AVE",
"address_2": "SUITE 8",
"city": "KENNEWICK",
"state": "WA",
"postal_code": "99336",
"telephone_number": "509-374-1660",
"fax_number": "509-374-9374"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5219 WEST CLEARWATER AVE",
"address_2": "SUITE 8",
"city": "KENNEWICK",
"state": "WA",
"postal_code": "99336",
"telephone_number": "509-374-1660",
"fax_number": "509-374-9374"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHELBY",
"first_name": "DIANA",
"middle_name": "SUE",
"credential": "DPD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122400000X",
"taxonomy_group": "",
"desc": "Denturist",
"state": "WA",
"license": "DN00000253",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "15049275",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kennewick, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.