Healthcare Provider Details

I. General information

NPI: 1225179518
Provider Name (Legal Business Name): BARBARA SHELLER D.D.S., MS.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2007
Last Update Date: 07/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 SAND POINT WAY NE MAILSTOP CD
SEATTLE WA
98105-3901
US

IV. Provider business mailing address

4800 SAND POINT WAY NE MAILSTOP CD
SEATTLE WA
98105-3901
US

V. Phone/Fax

Practice location:
  • Phone: 206-987-3754
  • Fax: 206-987-3891
Mailing address:
  • Phone: 206-987-3754
  • Fax: 206-987-3891

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDE00005618
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDE00005618
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: