Lynn Ellen Shelburne, DMD
Individual provider Active NPI General Practice Dentistry · Taylorsville, KY
NPI 1255334231 · NPPES record last updated Jul 19, 2017
Key facts
- NPI
- 1255334231
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 6101 (KY)
- Practice address
- 1477 Bloomfield Rd
Taylorsville, KY 40071-9009 - Phone
- (502) 477-8792
- Fax
- (502) 477-8792
- NPI assigned
- May 24, 2005
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6101 | KY | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| One Stop Smile Shop LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 6101 | KY | Yes |
Addresses
Primary practice location
1477 Bloomfield Rd
Taylorsville, KY 40071-9009
Mailing address
1477 Bloomfield Rd
Taylorsville, KY 40071-9009
Phone (502) 902-6120
Other providers in Taylorsville, KY
- Danielle Reid
- Sara Ann Salerno
- SCPG Kentucky LLC
- Cameron Seigle
- Jillian Sellers
- Alex Shields
- Smiles Delivered
- Kristen Smotherman
- SN Kentuckiana Rehab, LLC
- SN Kentuckiana Rehab, LLC
All providers in Taylorsville, KY · General Practice Dentistry in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 19, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.