Provider Demographics
NPI:1316511710
Name:OBERST, SHELBY PAIGE (DMD)
Entity type:Individual
Prefix:DR
First Name:SHELBY
Middle Name:PAIGE
Last Name:OBERST
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:SHELBY
Other - Middle Name:PAIGE
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:770 ROSE STREET
Mailing Address - Street 2:MN 324
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40508
Mailing Address - Country:US
Mailing Address - Phone:765-748-6151
Mailing Address - Fax:
Practice Address - Street 1:770 ROSE STREET
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40508
Practice Address - Country:US
Practice Address - Phone:859-273-5020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-19
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY105931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice