Sal Sheckley, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

D011079 Issued in AZ

Practice address

633 N Gilbert Rd
Mesa, AZ 85203-6629

Phone

(602) 932-2555

NPI assigned

Jun 24, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1624492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624492800000",
    "number": "1417527268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4114 N 28TH ST APT 3029",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850165943",
            "telephone_number": "714-423-7769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 N GILBERT RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852036629",
            "telephone_number": "602-932-2555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHECKLEY",
        "first_name": "SAL",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-24",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D011079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jay A Shechter, M.D.
• James David Sheehan, N.M.D.
• Samantha Leigh Sheeley, LAC, NCC
• Donna J Sheely, RN
• Mary Ann Sheely
• Shelly Clanton, Inc

• Dentist in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Dentist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 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.