Provider Demographics
NPI:1659608032
Name:SHELDON, DEAN FOSTER (DC)
Entity Type:Individual
Prefix:DR
First Name:DEAN
Middle Name:FOSTER
Last Name:SHELDON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96 N MAIN ST
Mailing Address - Street 2:STE 103
Mailing Address - City:CEDAR CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84720-3055
Mailing Address - Country:US
Mailing Address - Phone:435-867-8986
Mailing Address - Fax:435-867-6233
Practice Address - Street 1:96 N MAIN ST
Practice Address - Street 2:STE 103
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84720-3055
Practice Address - Country:US
Practice Address - Phone:435-867-8986
Practice Address - Fax:435-867-6233
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-05
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60118223111N00000X
UT8714152-0162111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8890581Medicare PIN