Individual provider Active NPI

Elizabeth Dincher Shelly, DDS

  • Dentist
  • Hilton Head Island, SC
National Provider Identifier
1710144431
Registry record updated May 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2852 Issued in SC
Practice address
800 Main St
Suite 120
Hilton Head Island, SC 29926-1656
Phone
(843) 681-8166
Fax
(843) 689-5275
NPI assigned
May 20, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2852 SC Primary

Addresses

Primary practice location

800 Main St
Suite 120
Hilton Head Island, SC 29926-1656

Mailing address

800 Main St
Suite 120
Hilton Head Island, SC 29926-1656
Phone (843) 681-8166

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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

Enrollment IDStateProvider typePAC IDDetails
I20250205002788 SC Order and Referring Only - DentistPractitioner - Dentist 1052841020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2852SCMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1211241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211241600000",
    "number": "1710144431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 MAIN ST",
            "address_2": "SUITE 120",
            "city": "HILTON HEAD ISLAND",
            "state": "SC",
            "postal_code": "299261656",
            "telephone_number": "843-681-8166",
            "fax_number": "843-689-5275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 MAIN ST",
            "address_2": "SUITE 120",
            "city": "HILTON HEAD ISLAND",
            "state": "SC",
            "postal_code": "299261656",
            "telephone_number": "843-681-8166",
            "fax_number": "843-689-5275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELLY",
        "first_name": "ELIZABETH",
        "middle_name": "DINCHER",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-20",
        "last_updated": "2008-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SC",
            "license": "2852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hilton Head Island, SC

Sources for this page

Verify at the official NPI Registry.