Shane Leslie Dentinger
Individual provider Active NPI Home Health Aide · Bloomville, OH
NPI 1689400962 · NPPES record last updated Sep 18, 2024
Key facts
- NPI
- 1689400962
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Home Health Aide 374U00000X
- Practice address
- PO Box 166
Bloomville, OH 44818-0166 - Phone
- (419) 494-7633
- NPI assigned
- Sep 12, 2024
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | Yes |
Addresses
Primary practice location
PO Box 166
Bloomville, OH 44818-0166
Mailing address
PO Box 166
Bloomville, OH 44818-0166
Phone (419) 494-7633
Other providers in Bloomville, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 18, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.