Provider Demographics
NPI:1215547922
Name:HERRMANN, SARAH ELIZABETH (DDS)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:ELIZABETH
Last Name:HERRMANN
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 1:2219 PAUL BUNYAN DR NW STE 6-7
Mailing Address - Street 2:
Mailing Address - City:BEMIDJI
Mailing Address - State:MN
Mailing Address - Zip Code:56601-6188
Mailing Address - Country:US
Mailing Address - Phone:218-751-2659
Mailing Address - Fax:
Practice Address - Street 1:2219 PAUL BUNYAN DR NW STE 6-7
Practice Address - Street 2:
Practice Address - City:BEMIDJI
Practice Address - State:MN
Practice Address - Zip Code:56601-6188
Practice Address - Country:US
Practice Address - Phone:218-751-2659
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-06
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD11279122300000X
TN11485122300000X
MND15015122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist