Provider Demographics
NPI:1174688865
Name:SHERR, INNA (DDS)
Entity Type:Individual
Prefix:DR
First Name:INNA
Middle Name:
Last Name:SHERR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7791 W SUNSET BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90046-3911
Mailing Address - Country:US
Mailing Address - Phone:323-850-5906
Mailing Address - Fax:323-850-0733
Practice Address - Street 1:7791 W SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90046-3911
Practice Address - Country:US
Practice Address - Phone:323-850-5906
Practice Address - Fax:323-850-0733
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA331641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB33164Medicaid