Provider Demographics
NPI:1578565081
Name:SHELHAMER, ALAN GENE (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:GENE
Last Name:SHELHAMER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6390 PASEO ASPADA
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-3011
Mailing Address - Country:US
Mailing Address - Phone:619-987-8008
Mailing Address - Fax:760-931-9981
Practice Address - Street 1:6221 METROPOLITAN ST
Practice Address - Street 2:SUITE #103
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92009-3096
Practice Address - Country:US
Practice Address - Phone:619-987-8008
Practice Address - Fax:760-931-9981
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2009-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA531631223S0112X
TX188461223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery