Provider Demographics
NPI:1073202784
Name:MOTSCHMAN, SHELBY AARON (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHELBY
Middle Name:AARON
Last Name:MOTSCHMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1124 TRALEE TRL
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45430-1219
Mailing Address - Country:US
Mailing Address - Phone:937-750-2845
Mailing Address - Fax:
Practice Address - Street 1:2355B FACULTY DR
Practice Address - Street 2:
Practice Address - City:USAF ACADEMY
Practice Address - State:CO
Practice Address - Zip Code:80840-1802
Practice Address - Country:US
Practice Address - Phone:937-750-2845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-08
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.027125122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist