Healthcare Provider Details

I. General information

NPI: 1568470250
Provider Name (Legal Business Name): SHELBY R. SMITHEY, D.D.S., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

431 KEISLER DR SUITE 101
CARY NC
27518-7064
US

IV. Provider business mailing address

431 KEISLER DR SUITE 101
CARY NC
27518-7064
US

V. Phone/Fax

Practice location:
  • Phone: 919-233-0073
  • Fax: 919-233-2933
Mailing address:
  • Phone: 919-233-0073
  • Fax: 919-233-2933

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: DR. SHELBY R. SMITHEY
Title or Position: PRESIDENT
Credential: D.D.S.
Phone: 919-233-0073