Kelly, Shaunda Elyse
Kelly, Shaunda Elyse is an individual health care provider with primary practice located at 2000 6Th Ave S , Birmingham AL 35233-2110. She recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as her primary health care specialty. Kelly, Shaunda Elyse can be contacted via phone (205) 934-9999.Contact Information
Primary practice address
2000 6Th Ave S
Birmingham AL 35233-2110
Phone: (205) 934-9999
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 5395 | Alabama |
Profile Details
| NPI number | 1659540508 |
|---|---|
| LBN Legal business name | Kelly, Shaunda Elyse |
| Credentials | MD, DMD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 25th, 2008 |
| Last updated | Mar 14th, 2012 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1659540508 | NPPES |
| Alabama | Other | 051118224 | BCBS |
| Alabama | MEDICAID | 130496 | BCBS |
| Alabama | Other | Z17060 | BCBS |
| Alabama | MEDICAID | 130492 | BCBS |
| Alabama | MEDICAID | 01281210 | BCBS |
| Alabama | MEDICAID | 130497 | BCBS |
| Alabama | Other | 051118219 | BCBS |
| Alabama | Other | 051118223 | BCBS |
| Alabama | Other | 051118226 | BCBS |
| Alabama | MEDICAID | 130494 | BCBS |
| Alabama | Other | 051118221 | BCBS |
| Alabama | MEDICAID | 130495 | BCBS |
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