Provider Demographics
NPI:1447373113
Name:SHELDON, LEE NELSON (DMD)
Entity type:Individual
Prefix:DR
First Name:LEE
Middle Name:NELSON
Last Name:SHELDON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2223 SARNO RD
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935-3003
Mailing Address - Country:US
Mailing Address - Phone:321-259-9980
Mailing Address - Fax:321-259-9336
Practice Address - Street 1:2223 SARNO RD
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-3003
Practice Address - Country:US
Practice Address - Phone:321-259-9980
Practice Address - Fax:321-259-9336
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN79611223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics