DR. SHELLY L. MCCOLM


Address: 12 W 8th St, Lawrence, KS 66044-2602
Phone: 7858320809

DR. SHELLY L. MCCOLM (NPI# 1073593992) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1073593992
Entity Type Individual
Full Name DR. SHELLY L. MCCOLM
Credential D.D.S.
Practice Address 12 W 8th St
Lawrence
KS 66044-2602
Mailing Address 5005 Inge Ct
Lawrence
KS 66049-4835
Practice Telephone 7858320809
Mailing Telephone 7858321782
Enumeration Date 2006-01-18
Last Update Date 2007-07-08
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1223X0400X Dentist
Specialization: Orthodontics and Dentofacial Orthopedics
KS7061 KS Dental Providers

Other Provider Identifier

State Issuer Identifier Type Code
KS 7061 KS7061 01

Office Location

Street Address 12 W 8TH ST
City LAWRENCE
State KS
Zip Code 66044-2602

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1922515899 The Magnolia Institute, LLC Community/Behavioral Health 729 1/2 Massachusetts. St., Suite 215, Lawrence, KS 66044 2018-01-02
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Taxonomy Information

Taxonomy Code 1223X0400X
Grouping Dental Providers
Classification Dentist
Specialization Orthodontics and Dentofacial Orthopedics

Taxonomy Definition

That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1649543554 The Braces Place Dentist 335 Common St, Lawrence, MA 01840-1262 2012-02-23
1538360342 Maurice George Theberge Dentist 50 Prospect Street, Suite 402, Lawrence, MA 01841 2007-05-30
1427268036 Don Gordy Dds Pa Dentist 721 Wakarusa Drive, Ste 102, Lawrence, KS 66049-4797 2007-05-23
1336252139 N. Daniel Ranjbar Dentist 4828 Quail Crest Pl, Lawrence, KS 66049-3838 2006-08-16
1760025480 Shira Bernstein Dentist 122 Harrison St, Lawrence, NY 11559-1932 2019-10-25
1184075038 Merrimack Valley Orthodontics LLC Dentist 100 Amesbury St, Suite 110, Lawrence, MA 01840-1321 2016-06-22
1407221377 Ana Serrenho Dentist 355 Essex St, Lawrence, MA 01840-1410 2015-12-03
1578939351 Jie Liu Dentist 234 Essex St, Lawrence, MA 01840-1549 2015-08-17
1235542903 Audra Buckley Reynoso Dentist 100 Amesbury St, Suite 110, Lawrence, MA 01840-1321 2014-06-10
1922303668 Lawrence Braces, P.C. Dentist 355 Essex St, Lawrence, MA 01840-1410 2011-01-11
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Competitor

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City LAWRENCE
Zip Code 66044

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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