# DR. SHANE AARON NELSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1619942083
- **Gender:** Man
- **Credential:** DDS

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 2016000952 | MO | — |
| 122300000X | Dentist | DN19850 | FL | — |
| 1223G0001X | General Practice Dentistry | 7117 | KS | Yes |

## Other

- **Enumeration date:** 02/21/2006
- **Last updated:** 07/09/2020