Johnette Joy Shelley, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

13029 Issued in TX

Practice address

BLDG 38717, 38TH St
USA Dentac
Ft Gordon, GA 30905-5660

Phone

(706) 787-6927

Fax

(706) 787-2082

NPI assigned

Dec 28, 2005

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Female

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": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1588641864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BLDG 38717, 38TH ST",
            "address_2": "USA DENTAC",
            "city": "FT GORDON",
            "state": "GA",
            "postal_code": "309055660",
            "telephone_number": "706-787-6927",
            "fax_number": "706-787-2082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BLDG 38717, 38TH ST",
            "address_2": "USA DENTAC",
            "city": "FT GORDON",
            "state": "GA",
            "postal_code": "309055660",
            "telephone_number": "706-787-6927",
            "fax_number": "706-787-2082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELLEY",
        "first_name": "JOHNETTE",
        "middle_name": "JOY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-28",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "13029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory J Sengstock, MD PHD
• Sherita Seward-Brown
• Elena Winter Shahbazi, M.D.
• David A Shapiro, M.D.
• Timothy Daniel Sheehan, M.D.
• Billy E Silas
• Jison Sim, D.O.
• Neidra Simmons, RN
• Rashanda Cherise Simmons, LPN
• Jennifer Ann Simpson, LMT, IANMT, CFT/CMT

• General Practice Dentistry in Fort Gordon, GA
• Providers in Fort Gordon, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.