Active NPI
Rosa Elena Pelaez-Shelton, DDS, MDS
- Pediatric Dentistry
- Farmington, CT
National Provider Identifier
1700014701
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 14278
- Practice address
- 263 Farmington Avenue
Farmington, CT 06030 - Phone
- (860) 859-5576
- NPI assigned
- Jun 29, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 14278 | CT | Primary |
Addresses
Primary practice location
263 Farmington Avenue
Farmington, CT 06030
Mailing address
10 Ferguson Way
Ellington, CT 06029-3004
Phone (860) 502-9384
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200424001367 | MA | Order and Referring Only - Dentist | 9436589942 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14278 | CT | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1246233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734652800000",
"number": "1700014701",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 FERGUSON WAY",
"city": "ELLINGTON",
"state": "CT",
"postal_code": "060293004",
"telephone_number": "860-502-9384"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "263 FARMINGTON AVENUE",
"city": "FARMINGTON",
"state": "CT",
"postal_code": "06030",
"telephone_number": "860-859-5576"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PELAEZ-SHELTON",
"first_name": "ROSA",
"middle_name": "ELENA",
"name_prefix": "Dr.",
"credential": "DDS, MDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-29",
"last_updated": "2024-12-20",
"certification_date": "2024-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "CT",
"license": "14278",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Farmington, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 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.