Provider Demographics
NPI:1023903135
Name:GUO, SHELLY (DDS)
Entity type:Individual
Prefix:DR
First Name:SHELLY
Middle Name:
Last Name:GUO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1012 SANDTRAP WAY
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-6581
Mailing Address - Country:US
Mailing Address - Phone:919-274-5173
Mailing Address - Fax:
Practice Address - Street 1:452 SHOTWELL RD
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-7397
Practice Address - Country:US
Practice Address - Phone:919-750-8484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-10
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC141821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice