Michael Richard Shelestak, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30024581 Issued in OH

Practice address

3115 Main St
West Middlesex, PA 16159-3411

Phone

(724) 528-1515

Fax

(724) 528-0217

NPI assigned

Jun 11, 2014

Last updated

Apr 9, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1402444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617926400000",
    "number": "1396158986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636896",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452636896",
            "telephone_number": "330-884-7158",
            "fax_number": "330-884-7175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3115 MAIN ST",
            "city": "WEST MIDDLESEX",
            "state": "PA",
            "postal_code": "161593411",
            "telephone_number": "724-528-1515",
            "fax_number": "724-528-0217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELESTAK",
        "first_name": "MICHAEL",
        "middle_name": "RICHARD",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-11",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS040096",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "FS4701428",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30024581",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Fedrizzi Jr.
• Jade George, M.S. CCC-SLP
• Aaron Listopad
• Hopeanne Lovrinoff-Moran, LMT
• Deborah Jean Marcucci, LCSW
• Richard A Shelestak, DMD
• Shenango TWP Vol Fire Dept Mercer Co PA (Shenango Twp Vol Fire Dept)
• Nicole Shingledecker, PHARM.D.
• Simply Science Nutrition Counseling LLC
• Upmc Community Medicine Inc (Horizon Family Medicine - UPMC - West Middlesex)

• General Practice Dentistry in West Middlesex, PA
• Providers in West Middlesex, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.