Provider Demographics
NPI:1346469244
Name:SHELTON, WHITNEY OWEN (DDS)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:OWEN
Last Name:SHELTON
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 1:1105 GLENEAGLES DR SW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-6405
Mailing Address - Country:US
Mailing Address - Phone:256-882-2466
Mailing Address - Fax:256-882-2402
Practice Address - Street 1:1105 GLENEAGLES DR SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-6405
Practice Address - Country:US
Practice Address - Phone:256-882-2466
Practice Address - Fax:256-882-2402
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALAL 41271223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry