Active NPI
Jacob Shelton, DDS
- General Practice Dentistry
- Thornton, CO
National Provider Identifier
1366010415
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 206029
- Practice address
- 13591 Grant St
Thornton, CO 80241-1131 - Phone
- (918) 810-5645
- NPI assigned
- Jun 15, 2021
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 206029 | CO | Primary |
Addresses
Primary practice location
13591 Grant St
Thornton, CO 80241-1131
Mailing address
13591 Grant St
Thornton, CO 80241-1131
Phone (918) 810-5645
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 |
|---|---|---|---|
| 206029 | CO | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780012800000",
"number": "1366010415",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13591 GRANT ST",
"city": "THORNTON",
"state": "CO",
"postal_code": "802411131",
"telephone_number": "918-810-5645"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13591 GRANT ST",
"city": "THORNTON",
"state": "CO",
"postal_code": "802411131",
"telephone_number": "918-810-5645"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHELTON",
"first_name": "JACOB",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-06-15",
"last_updated": "2026-05-29",
"certification_date": "2026-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CO",
"license": "206029",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Thornton, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.