SHELLY TAYLOR-SOETAN DMD
NPI 1508224155
Dentist - Periodontics in Bronx, NY
About Shelly Taylor-soetan Dmd NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SHELLY TAYLOR-SOETAN DMD (NPI 1508224155) is an individual periodontics provider in Bronx, New York, licensed in New York (062433-01) and active in the NPI registry since February 2016. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses 4
Other Names 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Shelly Taylor-soetan Dmd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 10453 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Shelly Taylor-soetan's NPI number?
The NPI number for Shelly Taylor-soetan is 1508224155. It was assigned to this individual provider in the NPPES registry on February 10, 2016. The provider is also known as Shelly Taylor Dmd.
Where is Shelly Taylor-soetan located?
Shelly Taylor-soetan practices at 1894 Walton Ave, Bronx, NY 10453. The listed phone number is (718) 583-2700.
What is Shelly Taylor-soetan's specialty?
The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.
Is Shelly Taylor-soetan enrolled in Medicare?
Yes. Shelly Taylor-soetan is registered in the Medicare PECOS enrollment system.
What insurance does Shelly Taylor-soetan accept?
Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and Humana and 1 other insurer list Shelly Taylor-soetan as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Shelly Taylor-soetan was last updated on October 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Shelly Taylor-Soetan, DMD · NPI 1508224155
Periodontics provider in Bronx, New York. Individual provider, active in the CMS NPPES registry since February 10, 2016.
## Identity
- **NPI:** 1508224155 (Entity type: Individual)
- **Enumerated:** February 10, 2016
- **Primary specialty:** Dentist - Periodontics · taxonomy 1223P0300X
- **State license:** 062433-01 (New York)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1894 WALTON AVE, Bronx, NY 10453-6018
- **Phone:** (718) 583-2700
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health
## Record status
- **NPPES last updated:** October 9, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1508224155) · Data from the CMS NPPES public registry.