Provider Demographics
NPI:1932337771
Name:BELL, SHAWN JACOB (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:JACOB
Last Name:BELL
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 1:2438 ANNA LAURA LN
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45431-3401
Mailing Address - Country:US
Mailing Address - Phone:614-743-9445
Mailing Address - Fax:
Practice Address - Street 1:8250 KENWOOD CROSSING WAY
Practice Address - Street 2:STE 220
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-3668
Practice Address - Country:US
Practice Address - Phone:513-961-1991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-01
Last Update Date:2012-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-0233891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice