NPIMap

Organization Active NPI

Melissa D Shotell DMD Ms Inc

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Sonora, CA
National Provider Identifier
1871963843
Registry record updated Oct 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
58232 Issued in CA
Legal business name
MELISSA D SHOTELL DMD MS INC
Practice address
14570 Mono Way Ste I
Sonora, CA 95370-8997
Phone
(209) 536-1954
NPI assigned
Oct 2, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2015

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

Authorized official

Name
Dr. Melissa D Shotell, DMD MSNPI 1790944098
Title
President
Phone
(209) 536-1954

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 58232 CA
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X 58232 CA Primary

Addresses

Primary practice location

14570 Mono Way Ste I
Sonora, CA 95370-8997

Mailing address

PO Box 217
Soulsbyville, CA 95372-0217
Phone (209) 536-1954

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1443744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443744000000",
    "number": "1871963843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 217",
            "city": "SOULSBYVILLE",
            "state": "CA",
            "postal_code": "953720217",
            "telephone_number": "209-536-1954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14570 MONO WAY STE I",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "953708997",
            "telephone_number": "209-536-1954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MELISSA D SHOTELL DMD MS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-02",
        "last_updated": "2015-10-02",
        "status": "A",
        "authorized_official_last_name": "SHOTELL",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "209-536-1954",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD MS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "58232",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "58232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sonora, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2015; 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.