Dr Shelly Rea Sullens, DMD is a
Dentist based in Canyonville, Oregon. Dr Shelly Rea Sullens is licensed to practice in Oregon (license number D6207) and her current practice location is
121 Sw 5th St, Canyonville, Oregon. She can be reached at her office (for appointments etc.) via phone at
(888) 468-0022.
NPI number for Dr Shelly Rea Sullens is 1124266804 and her current mailing address is 442 Sw Umatilla Ave, Suite 200, Redmond, Oregon. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1124266804.
Healthcare Provider's Profile
| Full Name | Dr Shelly Rea Sullens |
|---|
| Gender | Female |
|---|
| Speciality | Dentist |
|---|
| Location | 121 Sw 5th St, Canyonville, Oregon |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1124266804
- Provider Enumeration Date: 02/03/2009
- Last Update Date: 06/23/2015
Medical Identifiers
Medical identifiers for Dr Shelly Rea Sullens such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1124266804 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 122300000X | Dentist | D6207 (Oregon) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Shelly Rea Sullens is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Shelly Rea Sullens, DMD
442 Sw Umatilla Ave, Suite 200,
Redmond, OR 97756-7039
Ph: (541) 504-3900 | Dr Shelly Rea Sullens, DMD
121 Sw 5th St,
Canyonville, OR 97417-8718
Ph: (888) 468-0022 |
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