Provider Demographics
NPI:1801574702
Name:SHAFFER, SHELBY ALEXANDRA (DDS)
Entity type:Individual
Prefix:DR
First Name:SHELBY
Middle Name:ALEXANDRA
Last Name:SHAFFER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 GREENWOOD DR
Mailing Address - Street 2:
Mailing Address - City:NEW CUMBERLAND
Mailing Address - State:PA
Mailing Address - Zip Code:17070-3022
Mailing Address - Country:US
Mailing Address - Phone:610-850-2177
Mailing Address - Fax:
Practice Address - Street 1:3801 MARKET ST
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-4328
Practice Address - Country:US
Practice Address - Phone:717-737-8423
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0442221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice