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NPI Code Detail

MEDICARE: DR. SHELRETHIA O'SHAY BATTLE-SIATITA D.D.S

MEDICARE: DR. SHELRETHIA O'SHAY BATTLE-SIATITA D.D.S
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist23184TX
21223P0300XPeriodontics18400MD
31223P0300XPeriodontics0401412526VA

General Provider Information

NPI Number : 1417163833
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHELRETHIA O'SHAY BATTLE-SIATITA D.D.S
Provider Business Mailing Address
First Line : 2501 CAPEHART RD
Second Line :
City : OFFUTT AFB
State : NE
Zip : 68113-1043
Country : US
Telephone Number : 402-294-2448
Fax Number :
Provider Business Practice Location Address
First Line : 2501 CAPEHART RD
Second Line :
City : OFFUTT AFB
State : NE
Zip : 68113-1043
Country : US
Telephone Number : 402-294-2448
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2007
Last Update Date : 06/10/2026

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