Individual provider Active NPI

Shelby Eriksen, DMD

  • Dentist
  • Elizabethtown, KY
National Provider Identifier
1477394062
Registry record updated Oct 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
11165 Issued in KY
Practice address
3100 Ring Rd Ste 104
Elizabethtown, KY 42701-1282
Phone
(270) 982-3500
NPI assigned
Jun 5, 2024
Last updated
Oct 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 11165 KY Primary

Addresses

Primary practice location

3100 Ring Rd Ste 104
Elizabethtown, KY 42701-1282

Mailing address

517 Bewley Hollow Rd
Elizabethtown, KY 42701-6408
Phone (270) 505-3400

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

LicenseStateTypeSpecialty
11165KYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Marks Family Dentistry PLC Dentist CurrentSince Oct 21, 2025 Accepting new patients
Robinson Family Dental PSC Dentist PastSince Mar 24, 2025 Accepting new patients

Locations

3100 Ring Rd
Ste 104
Elizabethtown, KY 42701
Phone (270) 982-3500

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1717545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760659200000",
    "number": "1477394062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 BEWLEY HOLLOW RD",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427016408",
            "telephone_number": "270-505-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 RING RD STE 104",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427011282",
            "telephone_number": "270-982-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERIKSEN",
        "first_name": "SHELBY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-05",
        "last_updated": "2025-10-17",
        "certification_date": "2025-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "11165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethtown, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2025; 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.