JESSICA ELAINE SHELNUTT (NPI# 1912557117) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1912557117 |
Entity Type | Individual |
Full Name | JESSICA ELAINE SHELNUTT |
Practice Address |
10209 Se Sunnyside Rd Clackamas OR 97015-9782 |
Mailing Address |
5025 Se 28th Ave Portland OR 97202-4445 |
Practice Telephone | 5033533905 |
Mailing Telephone | 5032866868 |
Enumeration Date | 2019-09-19 |
Last Update Date | 2019-09-19 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223P0300X |
Dentist Specialization: Periodontics |
000412 | OR | Dental Providers |
Address | Telephone Number | Fax Number |
---|---|---|
5025 Se 28th Ave, Portland, OR 972024445 | 5032866868 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1447806229 | Jessica Stephens Shelnutt | Physical Therapist | 5415 Thompsons Mill Rd, Hoschton, GA 30548-4132 | 2019-08-16 |
1083091276 | Jessica Shelnutt | Physician Assistant | 1968 Peachtree Rd Nw, Atlanta, GA 30309-1281 | 2015-04-27 |
Street Address |
10209 SE SUNNYSIDE RD |
City | CLACKAMAS |
State | OR |
Zip Code | 97015-9782 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1184640062 | Harold Dean Geist | Dentist | 10209 Se Sunnyside Rd, Clackamas, OR 97015-9782 | 2006-07-14 |
1356972921 | Shi Li Luo | Dental Hygienist | 10209 Se Sunnyside Rd, Clackamas, OR 97015-9782 | 2020-01-31 |
1083256630 | Laura Ann Schaffner | Dental Hygienist | 10209 Se Sunnyside Rd, Clackamas, OR 97015-9782 | 2019-10-15 |
1205487329 | Sylvia Hill | Dental Assistant | 10209 Se Sunnyside Rd, Clackamas, OR 97015-9782 | 2019-09-20 |
1083187967 | Rose Booth | Dental Assistant | 10209 Se Sunnyside Rd, Clackamas, OR 97015-9782 | 2019-01-03 |
1043783913 | Jessica Nicole Hughes | Dental Assistant | 10209 Se Sunnyside Rd, Clackamas, OR 97015-9782 | 2019-01-03 |
1588137459 | Erin Mccormack | Dental Assistant | 10209 Se Sunnyside Rd, Clackamas, OR 97015-9782 | 2019-01-03 |
1356878771 | Stacey Irene Inloes | Dental Assistant | 10209 Se Sunnyside Rd, Clackamas, OR 97015-9782 | 2017-05-16 |
1619429842 | Kaiser Foundation Health Plan of The Northwest | Dentist | 10209 Se Sunnyside Rd, Clackamas, OR 97015-9782 | 2016-11-04 |
1235688474 | Tamie Resare | Dental Assistant | 10209 Se Sunnyside Rd, Clackamas, OR 97015-9782 | 2016-09-29 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1184103517 | Laurel Perilli | Physical Therapist | 12550 Se 93rd Ave Ste 265, Clackamas, OR 97015 | 2018-08-07 |
1306324538 | Kristin Connor Messing | Physical Therapist | 4805 Ne Glisan St, Prov Hall 7e06, Portland, OR 97015 | 2018-07-31 |
1902317266 | Darcy Jones Hamrick | Counselor | 12901 Se 97th Ave., Suite 340, Clackamas, OR 97015 | 2017-10-13 |
1841723384 | Manon Lavoie | Chiropractor | 17105 Se Sunnyside Rd, Suite 148, Happy Valley, OR 97015 | 2017-04-11 |
1235670126 | Michael G Short | Pedorthist | 10117 Se Sunnyside Rd., Ste. H, Clackamas, OR 97015 | 2017-03-13 |
1487100756 | Michael Joseph Peizner | Pharmacist | 16300se Evelyn Street, Clackamas, OR 97015 | 2016-08-28 |
1316395619 | Jennifer Elaine Walkowski | Physical Therapist | 9100 Se Sunnyside Road, Clackamas, OR 97015 | 2016-05-26 |
1649635384 | Brookside Dental - Milwaukie, LLC | Dentist | 9225 Se Sunnyside Rd. Ste 1, Clackamas, OR 97015 | 2015-12-23 |
1801216130 | Robert D. Grew Dmd, Inc. | Dentist | 10163 Se Sunnyside Road, Suite 414, Clackamas, OR 97015 | 2014-04-25 |
1508205410 | Valerie P Tabalno | Massage Therapist | 15661 Se 82nd Dr, Clackamas, OR 97015 | 2013-06-25 |
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Taxonomy Code | 1223P0300X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Periodontics |
That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1669479416 | David W Compton | Dentist | 10163 Se Sunnyside Rd, Suite 450, Clackamas, OR 97015-5743 | 2005-07-07 |
1992099964 | David W. Compton, Dmd, Ms, PC | Dentist | 10163 Se Sunnyside Rd, Suite 450, Clackamas, OR 97015-5743 | 2011-06-07 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1871026062 | Leila Soltani | Dentist | 430 Sw 13th Ave Apt 2010, Portland, OR 97205 | 2017-04-05 |
1427504828 | Shashank Joshi | Dentist | 1739 W Harvard Ave, Roseburg, OR 97471-2716 | 2016-08-26 |
1982056479 | Mari Heslinga | Dentist | 21332 Sw Langer Farms Pkwy Ste 126, Sherwood, OR 97140 | 2016-07-07 |
1376944314 | Mikhail Garibov | Dentist | 17895 Nw Evergreen Pkwy Ste 130, Beaverton, OR 97006-7402 | 2014-09-09 |
1548671340 | Polaris Dental Specialists | Dentist | 620 12th Street Se, Salem, OR 97301 | 2014-05-14 |
1295159986 | Andrew N Dow Dmd PC | Dentist | 4750 Village Plaza Loop Ste 102, Eugene, OR 97401-6601 | 2014-02-14 |
1043581465 | Riverplace Periodontics PC | Dentist | 2636 Se Harrison Street, Suite A, Milwaukie, OR 97222 | 2012-01-17 |
1730472986 | Wilson D Lee | Dentist | 315 Nw Lost Springs Ter, #401, Portland, OR 97229-6444 | 2011-05-20 |
1184954422 | Kamran Haghighat Bds Ms PC | Dentist | 833 Sw 11th Ave Ste 1020, Portland, OR 97205-2124 | 2010-01-08 |
1467683276 | Sunny L Drake | Dentist | 2235 Mission St Se Ste 250, Salem, OR 97302-1294 | 2009-07-29 |
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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.