Peter Quinn Shelley, D.D.S, M.S.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

DEN-9228 Issued in CO

Practice address

13605 Xavier Lane
Unit E
Broomfield, CO 80020-0000

Phone

(303) 427-2769

Fax

(303) 427-1782

NPI assigned

Jul 27, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Elm Endodontics PC

  • Endodontics
  • Broomfield, CO
  • NPI 1306665385
  NPD Authorized official

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343865600000",
    "number": "1952315079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13605 XAVIER LANE",
            "address_2": "UNIT E",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800200000",
            "telephone_number": "303-427-2769",
            "fax_number": "303-427-1782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13605 XAVIER LANE",
            "address_2": "UNIT E",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800200000",
            "telephone_number": "303-427-2769",
            "fax_number": "303-427-1782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELLEY",
        "first_name": "PETER",
        "middle_name": "QUINN",
        "name_prefix": "Dr.",
        "credential": "D.D.S, M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2012-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CO",
            "license": "DEN-9228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyle Shaw, MA CF-SLP
• Merissa Anne Shayler, LCSW
• Cynthia Mae Sheeks, D.D.S.
• Carleen A Sheely Kirkland, R. EEG T
• Savannah Amy Sheets, MA, LPCC
• Diane Rene Shelton, PSYD
• Samantha Christine Shelton
• Diana Shenkin, LCSW
• Natasha Dove Shephard, CMT
• Shuangqiao Shi

• Endodontics in Broomfield, CO
• Providers in Broomfield, CO by specialty
• Endodontics in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2012; 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.