Shelton Dental PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DI10706 Issued in NJ

Legal business name

SHELTON DENTAL PA

Practice address

573 Martin Luther King Jr Blvd
Newark, NJ 07102-1215

Phone

(973) 622-3614

Fax

(973) 792-0820

NPI assigned

Sep 18, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Godfrey P Shelton, D.M.D.NPI 1811977598

Title

Owner

Phone

(973) 622-3614

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Shelton Dental PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Shelton Dental PA

  • General Practice Dentistry
  • Newark, NJ
  • NPI 1295861987
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Godfrey P Shelton, D.M.D.

  • General Practice Dentistry
  • Newark, NJ
  • NPI 1811977598
  NPD (past) Authorized official

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

{
    "created_epoch": "1190073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331596800000",
    "number": "1487840070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "192 PROSPECT AVE",
            "city": "MAYWOOD",
            "state": "NJ",
            "postal_code": "076071200",
            "telephone_number": "973-622-3614",
            "fax_number": "973-792-0820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "573 MARTIN LUTHER KING JR BLVD",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071021215",
            "telephone_number": "973-622-3614",
            "fax_number": "973-792-0820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHELTON DENTAL PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-18",
        "last_updated": "2012-03-13",
        "status": "A",
        "authorized_official_last_name": "SHELTON",
        "authorized_official_first_name": "GODFREY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-622-3614",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "DI10706",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2639700",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nikith Shekar, DO
• Mallika Shekhar
• Alkaben R Sheladia, MSN, FNP-C
• Katherine Sheldon, PHARMD, RPH
• Shelton Dental PA
• Shelton Oral Surgery PA
• Bryannah Shelton
• Godfrey P Shelton, D.M.D.
• William Shelton Jr., D.D.S.
• Sherry Manon Sheppard, MD

• General Practice Dentistry in Newark, NJ
• Providers in Newark, NJ by specialty
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2012; 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.