Shelly Elkins Long, PHDHP
Individual provider Active NPI Dental Hygienist · Slatington, PA
NPI 1306333760 · NPPES record last updated Jun 16, 2018
Key facts
- NPI
- 1306333760
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dental Hygienist 124Q00000X
- License
- PHDHP000713 (PA)
- Practice address
- 3826 Javalyn CT
Slatington, PA 18080-3822 - Phone
- (610) 657-9244
- NPI assigned
- Apr 20, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| PHDHP000713 | PA | MD | Dental Hygienist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | PHDHP000713 | PA | Yes |
Addresses
Primary practice location
3826 Javalyn CT
Slatington, PA 18080-3822
Mailing address
3826 Javalyn CT
Slatington, PA 18080-3822
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PHDH000713 | Other | PA | PA STATE BOARD OF DENTISTRY |
NPI Registry JSON
{
"created_epoch": "1524182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529107200000",
"number": "1306333760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3826 JAVALYN CT",
"city": "SLATINGTON",
"state": "PA",
"postal_code": "180803822"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3826 JAVALYN CT",
"city": "SLATINGTON",
"state": "PA",
"postal_code": "180803822",
"telephone_number": "610-657-9244"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELKINS LONG",
"first_name": "SHELLY",
"name_prefix": "Mrs.",
"credential": "PHDHP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-04-20",
"last_updated": "2018-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "PA",
"license": "PHDHP000713",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PA STATE BOARD OF DENTISTRY",
"identifier": "PHDH000713",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
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All providers in Slatington, PA · Dental Hygienist in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 16, 2018. 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.