Shelley Wilkerson McDonald, D.M.D.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

3468-08 Issued in MS

Practice address

1922 23Rd Ave
Meridian, MS 39301-3107

Phone

(601) 482-8986

Fax

(601) 482-6100

NPI assigned

Jul 10, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Shelley W. McDonald, DMD, PA

  • Pediatric Dentistry
  • Meridian, MS
  • NPI 1285395517
  NPD Authorized official

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

{
    "created_epoch": "1215648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561420800000",
    "number": "1760646509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1922 23RD AVE",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393013107",
            "telephone_number": "601-482-8986",
            "fax_number": "601-482-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1922 23RD AVE",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393013107",
            "telephone_number": "601-482-8986",
            "fax_number": "601-482-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "SHELLEY",
        "middle_name": "WILKERSON",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-10",
        "last_updated": "2019-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MS",
            "license": "3468-08",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MS",
            "license": "3468-08",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yolanda Denice McDade, LPC-S
• Jessica Boswell McDaniel, FNP
• Allison Denise McDonald, MSN, WHNP-BC
• Angela McDonald, FNP
• Phillip K McDonald, M.D.
• John Dubard McEachin, M.D.
• Lawrence Benjamin McEachin, MD
• Melissa Lynn McElhenney, NP
• Marcia T McElroy
• Thomas M. McFarland, M.D.

• Pediatric Dentistry in Meridian, MS
• Providers in Meridian, MS by specialty
• Pediatric Dentistry in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2019; 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.