Active NPI
Shellie Horn, RDH
- Dental Hygienist
- Benton Harbor, MI
National Provider Identifier
1114683620
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 2902012142
- Practice address
- 800 M 139
Benton Harbor, MI 49022-3881 - Phone
- (855) 869-6900
- NPI assigned
- Nov 10, 2021
- 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 |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 2902012142 | MI | Primary |
Addresses
Primary practice location
800 M 139
Benton Harbor, MI 49022-3881
Mailing address
50 Industrial Park Rd
Bangor, MI 49013-1246
Phone (269) 427-7937
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 |
|---|---|---|---|
| 2902012142 | MI | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1636502400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636502400000",
"number": "1114683620",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "50 INDUSTRIAL PARK RD",
"city": "BANGOR",
"state": "MI",
"postal_code": "490131246",
"telephone_number": "269-427-7937",
"fax_number": "269-427-5180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 M 139",
"city": "BENTON HARBOR",
"state": "MI",
"postal_code": "490223881",
"telephone_number": "855-869-6900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HORN",
"first_name": "SHELLIE",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-11-10",
"last_updated": "2021-11-10",
"certification_date": "2021-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "MI",
"license": "2902012142",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Benton Harbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.