Provider Demographics
NPI:1356587307
Name:SHELDON, ELIZABETH JANE (DDS)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:JANE
Last Name:SHELDON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9692 LEVIN RD NW
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-7801
Mailing Address - Country:US
Mailing Address - Phone:360-613-5000
Mailing Address - Fax:
Practice Address - Street 1:9692 LEVIN RD NW
Practice Address - Street 2:SUITE 201
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-7801
Practice Address - Country:US
Practice Address - Phone:360-613-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-22
Last Update Date:2008-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60055543(PENDING)1223X0400X
NE66761223X0400X
WI5640-151223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics