Selden P Skelly, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901009565 Issued in MI

Practice address

24718 Michigan Ave
Dearborn, MI 48124

Phone

(313) 565-3131

Fax

(313) 565-7103

NPI assigned

Aug 25, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

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

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Royal Dentistry PLLC

  • General Practice Dentistry
  • Dearborn, MI
  • NPI 1427420165
  NPD (past)
• Skelly & Zager DDS PC

  • General Practice Dentistry
  • Dearborn, MI
  • NPI 1679681126
  NPD (past)

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760590202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24718 MICHIGAN AVE",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "48124",
            "telephone_number": "313-565-3131",
            "fax_number": "313-565-7103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24718 MICHIGAN AVE",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "48124",
            "telephone_number": "313-565-3131",
            "fax_number": "313-565-7103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKELLY",
        "first_name": "SELDEN",
        "middle_name": "P",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901009565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4048657",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristina Darlington Sitarski
• Mauran Sivananthan, D.O.
• Maryam Sizar
• Prairie Peace Skazalski
• Skelly & Zager DDS PC
• Thomas Skelton
• Yolanda L Skelton, LCSW AND LMSW
• Christopher Skinner
• Kseniia Skorniakova
• Christian Skowronski, MD

• General Practice Dentistry in Dearborn, MI
• Providers in Dearborn, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.