Active NPI
Lexington R Shelley Jr., DMD
- Periodontics
- Aiken, SC
National Provider Identifier
1205845708
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 2137
- Practice address
- 1420 Richland Avenue W
Aiken, SC 29801 - Phone
- (803) 648-9348
- Fax
- (803) 648-9376
- NPI assigned
- Aug 5, 2006
- 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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 2137 | SC | Primary |
Addresses
Primary practice location
1420 Richland Avenue W
Aiken, SC 29801
Mailing address
1420 Richland Avenue W
Aiken, SC 29801
Phone (803) 648-9348
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 |
|---|---|---|---|
| 2137 | SC | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1205845708",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1420 RICHLAND AVENUE W",
"city": "AIKEN",
"state": "SC",
"postal_code": "29801",
"telephone_number": "803-648-9348",
"fax_number": "803-648-9376"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1420 RICHLAND AVENUE W",
"city": "AIKEN",
"state": "SC",
"postal_code": "29801",
"telephone_number": "803-648-9348",
"fax_number": "803-648-9376"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHELLEY",
"first_name": "LEXINGTON",
"middle_name": "R",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "SC",
"license": "2137",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aiken, SC
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.