Provider Demographics
NPI:1700047313
Name:MURPHY, SHELLEY IRVING (DMD)
Entity Type:Individual
Prefix:DR
First Name:SHELLEY
Middle Name:IRVING
Last Name:MURPHY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:SHELLEY
Other - Middle Name:DIANE
Other - Last Name:IRVING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:9 EXECUTIVE PARK RD STE B
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29928-4703
Mailing Address - Country:US
Mailing Address - Phone:843-842-2300
Mailing Address - Fax:843-842-3065
Practice Address - Street 1:9 EXECUTIVE PARK RD STE B
Practice Address - Street 2:
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29928-4703
Practice Address - Country:US
Practice Address - Phone:843-842-2300
Practice Address - Fax:843-842-3065
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-17
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD91001223D0001X
SC6943122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223D0001XDental ProvidersDentistDental Public Health