Dr. Robert B. Shellworth , DDS
Dentist - General Practice • Boise, ID
Notice of NPI Deactivation & Inactive Practice Status
According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Robert Shellworth has officially deactivated this NPI record and ceased active healthcare practice.
Professional Overview & Biography Verified Profile Summary
Dr. Robert Shellworth, DDS was a registered Dentist - General Practice practicing in Boise, ID. Throughout an active medical career spanning 17 years, Dr. Shellworth provided care at the practice location at 210 W MALLARD DR until profile deactivation on 2023-01-25.
Practice Location & Contact Primary Location
210 W Mallard Dr
Boise, ID 837066642
Specialty Benchmarks & Practice Insights
Comparative analytics for Dentist - General Practice in Boise, ID
Practicing in Boise, ID (781 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Medical Specialties & State Licenses
NUCC Taxonomy Code: 1223G0001X
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Career & Practice History Timeline
Chronological log of verified NPI updates, location relocations, credentials, and registry changes
Record deactivated on January 25, 2023
NPI status registered as active in NPPES database
Registered at 210 W MALLARD DR, BOISE, ID 837066642 (Tel: 2083869472)
Registered at 1814 EDGECLIFF TER, BOISE, ID 837022911 (Tel: 2083368018)
Recorded as ROBERT SHELLWORTH, D.D.S.
Dentist (License #D1511 in ID)
First registered as active Individual Practitioner in NPPES Database.
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NPI Administrative Meta
Mailing Address
1814 Edgecliff Ter
Boise, ID 837022911
Phone: 2083368018
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