Individual provider Active NPI

Shelby Stein Sheeran, DMD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Lexington, KY
National Provider Identifier
1417432899
Registry record updated Jun 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
10115 Issued in KY
Practice address
3141 Beaumont Centre Cir Ste 200
Lexington, KY 40513-1956
Phone
(859) 296-4846
NPI assigned
Oct 1, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 10115 KY
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 10115 KY Primary

Addresses

Primary practice location

3141 Beaumont Centre Cir Ste 200
Lexington, KY 40513-1956

Mailing address

5089 Sulphur LN
Lexington, KY 40509-8427
Phone (270) 769-8461

Other identifiers 1

IdentifierTypeStateIssuer
10115OtherKYLICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20181120002994 KY Order and Referring Only - DentistPractitioner - Dentist 8729332135

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Arrow Dental PLLC Orthodontics and Dentofacial Orthopedics PastSince Jun 6, 2021 Accepting new patients
White, Greer and Maggard, PSC Orthodontics and Dentofacial Orthopedics PastSince Jun 6, 2021 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1538352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1417432899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5089 SULPHUR LN",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405098427",
            "telephone_number": "270-769-8461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3141 BEAUMONT CENTRE CIR STE 200",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405131956",
            "telephone_number": "859-296-4846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEERAN",
        "first_name": "SHELBY",
        "middle_name": "STEIN",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-01",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "10115",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "KY",
            "license": "10115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "10115",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.