Individual
DR. SHANE KRISTOFFER HELMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
200 TELETECH DRIVE, BUILDING 1, SUITE A, MOUNDSVILLE, WV 26041-1423
(304) 845-0809
(304) 845-0499
Mailing address
200 TELETECH DRIVE, BUILDING 1, SUITE A, MOUNDSVILLE, WV 26041-1423
(304) 845-0809
(304) 845-0499
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3476
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1400654
UNITED CONCORDIA PROVIDER
—
05
—
2003313-000
WV MEDICAID NUMBER
WV
05
—
2339919
OHIO MEDICAID NUMBER
OH
Enumeration date
08/31/2006
Last updated
07/16/2007
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