Individual provider Active NPI

Shelby Mural Esry, D.D.S

  • Dentist
  • Rogers, AR
National Provider Identifier
1346658242
Registry record updated Aug 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
3990 Issued in AR
Practice address
214 S 3Rd St
Rogers, AR 72756-4547
Phone
(479) 636-4771
NPI assigned
Jul 24, 2014
Last updated
Aug 6, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 3990 AR Primary

Addresses

Primary practice location

214 S 3Rd St
Rogers, AR 72756-4547

Mailing address

214 S 3Rd St
Rogers, AR 72756-4547
Phone (479) 636-4771

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150611000131 AR Order and Referring Only - DentistPractitioner - Dentist 9436470820

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3990ARMDDentist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1406160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785974400000",
    "number": "1346658242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 S 3RD ST",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727564547",
            "telephone_number": "479-636-4771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 S 3RD ST",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727564547",
            "telephone_number": "479-636-4771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESRY",
        "first_name": "SHELBY",
        "middle_name": "MURAL",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-24",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AR",
            "license": "3990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogers, AR

Sources for this page

Verify at the official NPI Registry.