Provider Demographics
NPI:1235134206
Name:SHERWOOD, CYNTHIA E
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:E
Last Name:SHERWOOD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 964
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:KS
Mailing Address - Zip Code:67301-0964
Mailing Address - Country:US
Mailing Address - Phone:620-331-4499
Mailing Address - Fax:620-331-4592
Practice Address - Street 1:308 N 6TH ST
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:KS
Practice Address - Zip Code:67301-3129
Practice Address - Country:US
Practice Address - Phone:620-331-4499
Practice Address - Fax:620-331-4592
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS5843122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS08364OtherBC/BS