Provider Demographics
NPI:1679680961
Name:SHELDON, DOXEY RANSOM (DMD)
Entity Type:Individual
Prefix:DR
First Name:DOXEY
Middle Name:RANSOM
Last Name:SHELDON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:MRS
Other - First Name:DOXEY
Other - Middle Name:SHELDON
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:809 S. LINDBERGH BLVD
Mailing Address - Street 2:
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63131-2824
Mailing Address - Country:US
Mailing Address - Phone:314-991-0103
Mailing Address - Fax:314-991-5417
Practice Address - Street 1:809 S. LINDBERGH BLVD
Practice Address - Street 2:
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-2824
Practice Address - Country:US
Practice Address - Phone:314-991-0103
Practice Address - Fax:314-991-5417
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOMO 13205122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist