Provider Demographics
NPI:1689288755
Name:SHELTON, INDI ARRINGTON (DDS)
Entity type:Individual
Prefix:
First Name:INDI
Middle Name:ARRINGTON
Last Name:SHELTON
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 EASLEY BRIDGE RD APT 30032
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29611-5157
Mailing Address - Country:US
Mailing Address - Phone:803-236-0973
Mailing Address - Fax:
Practice Address - Street 1:440 W SAM RIDLEY PKWY
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-2998
Practice Address - Country:US
Practice Address - Phone:615-768-3242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-04
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN116991223G0001X
SC101161223G0001X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program