Shelby Nelson, D.D.S., M.S.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

24664 Issued in TX

Practice address

3833 Camp Bowie Blvd
Fort Worth, TX 76107-3355

Phone

(817) 738-2334

Fax

(817) 738-1242

NPI assigned

Aug 11, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Dr. Shelby Nelson DDS, LLC

  • Periodontics
  • Ft Worth, TX
  • NPI 1669026555
  NPD Authorized official
• Keller Smiles LLC

  • Dental Clinic/Center
  • Keller, TX
  • NPI 1104478635
  NPD
• Smiles of Fort Worth, LLC

  • Dental Clinic/Center
  • Fort Worth, TX
  • NPI 1750933115
  NPD

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

{
    "created_epoch": "1249948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1528290426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3833 CAMP BOWIE BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761073355",
            "telephone_number": "817-738-2334",
            "fax_number": "817-738-1242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3833 CAMP BOWIE BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761073355",
            "telephone_number": "817-738-2334",
            "fax_number": "817-738-1242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "SHELBY",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-11",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "24664",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "24664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marian K Nelson, CRNA
• Mark J Nelson, M.D.
• Monica J Nelson, PMHNP
• Rochelle Ann Nelson, MA, BCBA
• Sean P Nelson, LVN
• Sofia Grace Nelson, LPC-ASSOCIATE
• Steven Nelson, AGACNP-BC
• Sudon Michelle Nelson
• Thomas Kevin Nelson, D.O.
• Tiffany Ann Nelson

• Periodontics in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Periodontics in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.