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General NPI Number Information
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NPI Number | 1164153300
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Entity Type | Individual
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Provider Name | SHELBY SARRADET HEALEY DDS
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Gender | Female
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Dates
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Enumeration Date | 06/20/2022
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Last Update Date | 02/25/2025
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Provider Practice Location Address
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Address Line | 9360 RICHMOND HWY
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City | LORTON
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State | VA
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Zip | 22079-1827
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Country | US
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Telephone | 703-495-9992
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Fax |
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Provider Business Mailing Address
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Address Line | 11728 DECADE CT
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City | RESTON
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State | VA
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Zip | 20191-2942
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Country | US
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Telephone | 512-363-0215
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | D-0007077-C1
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 39426
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 0401419208
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License Number State | VA
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