Provider Demographics
NPI:1285386342
Name:STERKEL, SHELBY (DENTAL HYGIENIST)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:
Last Name:STERKEL
Suffix:
Gender:F
Credentials:DENTAL HYGIENIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:955 5TH ST
Mailing Address - Street 2:
Mailing Address - City:BERTHOUD
Mailing Address - State:CO
Mailing Address - Zip Code:80513-1182
Mailing Address - Country:US
Mailing Address - Phone:970-420-0131
Mailing Address - Fax:
Practice Address - Street 1:820 1ST ST
Practice Address - Street 2:
Practice Address - City:LIMON
Practice Address - State:CO
Practice Address - Zip Code:80828-5008
Practice Address - Country:US
Practice Address - Phone:719-344-7185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-20
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODH.002024390124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes124Q00000XDental ProvidersDental HygienistGroup - Single Specialty