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SHELIA Y KENNEBREW DDS. MS. PC NPI 1689043192


NPI Information

NPI: 1689043192
Provider Name: SHELIA Y KENNEBREW DDS., MS., PC
Classification: Dentist - 1223P0300X
Entity Type: Organization

Specialization: Periodontics

Address:
29556 SOUTHFIELD RD
SUITE 100
SOUTHFIELD, MI
ZIP 48076
Phone: (248) 552-1195
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SHELIA Y KENNEBREW DDS., MS., PC is a periodontics dentist in Southfield, MI. The provider is that specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. SHELIA Y KENNEBREW DDS., MS., PC NPI is 1689043192. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

29556 SOUTHFIELD RD
SUITE 100
SOUTHFIELD, MI
ZIP 48076-021
Phone: (248) 552-1195
Fax: (248) 552-0980

The provider's authorized official is Shelia Yvette Kennebrew Horton .
The authorized official title is Periodontist/owner and has the following contact phone number (248) 552-1195.

The enumeration date for this NPI number is 9/15/2015 and was last updated on 9/15/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223P0300XDentistPeriodonticsD2901015296MICHIGANYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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