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Shelly Self Dmd Pllc

Dental Clinic/Center in Poulsbo, WA · enumerated 2014 · authorized official Mckinley Self, Manager.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1780003723

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Registry record

Entity type Organization (Type 2)
Legal business name Shelly Self Dmd Pllc
Other name <Unavail>
Practice address 19365 7th Ave Ne, Suite D 108, Poulsbo, WA, 98370
Phone (360) 779-7115
Fax (360) 779-3990
Enumeration date Apr 7, 2014
Last updated in NPPES Apr 7, 2014

Taxonomy & classification

261QD0000X Dental Clinic/Center Ambulatory Health Care Facilities · License DE10256 (WA) Primary

Authorized official

Name Mckinley Self
Title Manager
Phone (360) 464-0779

Other identifiers

Identifier Type State Issuer
5003603 Medicaid WA -
1008098 Medicaid WA -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

Who is the authorized official for Shelly Self Dmd Pllc?
NPPES lists Mckinley Self (Manager) as the authorized official for this organization.
What is the NPI number for Shelly Self Dmd Pllc?
The NPI for Shelly Self Dmd Pllc is 1780003723, a Type 2 (organization) record in the CMS NPPES registry.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2014-04-07.