Provider Demographics
NPI:1164682928
Name:LAI, SHERRIE I-AN (DDS, MS)
Entity Type:Individual
Prefix:
First Name:SHERRIE
Middle Name:I-AN
Last Name:LAI
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:I-AN
Other - Middle Name:
Other - Last Name:LAI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS, MS
Mailing Address - Street 1:13620 38TH AVE STE 5C
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-4233
Mailing Address - Country:US
Mailing Address - Phone:718-661-1186
Mailing Address - Fax:
Practice Address - Street 1:13620 38TH AVE STE 5C
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-4233
Practice Address - Country:US
Practice Address - Phone:718-661-1186
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-13
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052612-11223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics