Active NPI
Shellea J Altman
- Dentist
- Mendota Heights, MN
National Provider Identifier
1225458458
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 0401008462
- Practice address
- 576 High Ridge Circle
Mendota Heights, MN 55118 - Phone
- (651) 330-8779
- NPI assigned
- Apr 28, 2014
- 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 | 0401008462 | VA | Primary |
Addresses
Primary practice location
576 High Ridge Circle
Mendota Heights, MN 55118
Mailing address
576 High Ridge Circle
Mendota Heights, MN 55118
Phone (651) 330-8779
Other names 1
- Shellea J Miller
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 |
|---|---|---|---|
| 0401008462 | VA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1398643200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398643200000",
"number": "1225458458",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "576 HIGH RIDGE CIRCLE",
"city": "MENDOTA HEIGHTS",
"state": "MN",
"postal_code": "55118",
"telephone_number": "651-330-8779"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "576 HIGH RIDGE CIRCLE",
"city": "MENDOTA HEIGHTS",
"state": "MN",
"postal_code": "55118",
"telephone_number": "651-330-8779"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALTMAN",
"first_name": "SHELLEA",
"middle_name": "J",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-04-28",
"last_updated": "2014-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "VA",
"license": "0401008462",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SHELLEA",
"last_name": "MILLER",
"middle_name": "J",
"credential": "DDS",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Mendota Heights, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.