Provider Demographics
NPI:1356557292
Name:SHELDEN, ROSS CHARLES (DDS)
Entity type:Individual
Prefix:DR
First Name:ROSS
Middle Name:CHARLES
Last Name:SHELDEN
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 1:16260 VENTURA BLVD STE 404
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2238
Mailing Address - Country:US
Mailing Address - Phone:818-986-7411
Mailing Address - Fax:818-986-7422
Practice Address - Street 1:16260 VENTURA BLVD STE 404
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2238
Practice Address - Country:US
Practice Address - Phone:818-986-7411
Practice Address - Fax:818-986-7422
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA338501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice