Provider Demographics
NPI:1124753264
Name:SHAUF, DENA LYNN (RDH)
Entity type:Individual
Prefix:
First Name:DENA
Middle Name:LYNN
Last Name:SHAUF
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:299 HICKORY HILL RD
Mailing Address - Street 2:
Mailing Address - City:SIX MILE RUN
Mailing Address - State:PA
Mailing Address - Zip Code:16679-9209
Mailing Address - Country:US
Mailing Address - Phone:814-977-7517
Mailing Address - Fax:
Practice Address - Street 1:626 WATER ST STE 1
Practice Address - Street 2:
Practice Address - City:ORBISONIA
Practice Address - State:PA
Practice Address - Zip Code:17243-9432
Practice Address - Country:US
Practice Address - Phone:814-447-5556
Practice Address - Fax:814-447-3194
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADH011221L124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist