Shelby Allison Alexander, D.D.S., M.S.
Individual provider Active NPI Dentist · Morgantown, WV
NPI 1265879902 · NPPES record last updated Mar 17, 2018
Key facts
- NPI
- 1265879902
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 4053 (WV)
- Practice address
- 451 Suncrest Town Centre Dr
Morgantown, WV 26505-1814 - Phone
- (304) 293-5831
- NPI assigned
- Jun 3, 2013
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WV
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160415001202 | WV | Order and Referring Only - Oral Surgery |
1658679188 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4053 | WV | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Diana O Frum DDS Inc | Past | Accepting new patients | |
| Cglddsmorgantown | Dentist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 4053 | WV | Yes |
Addresses
Primary practice location
451 Suncrest Town Centre Dr
Morgantown, WV 26505-1814
Mailing address
513 Pinnacle Height Dr
Morgantown, WV 26505-8067
Phone (856) 625-0961
Other practice location 1
PO Box 9495
Morgantown, WV 26506-9495
Phone (304) 293-4398
Other practice location 2
406 Holland Ave
Westover, WV 26501-4209
Phone (304) 296-3786
Other providers in Morgantown, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 17, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.