Provider Demographics
NPI:1235719345
Name:VANDERPOOL, SHERI K (RDH)
Entity Type:Individual
Prefix:MRS
First Name:SHERI
Middle Name:K
Last Name:VANDERPOOL
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:SHERI
Other - Middle Name:K
Other - Last Name:VANDERPOOL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RDH
Mailing Address - Street 1:10427 ULMERTON RD STE B-3
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33771-3530
Mailing Address - Country:US
Mailing Address - Phone:727-535-9993
Mailing Address - Fax:727-530-1958
Practice Address - Street 1:10427 ULMERTON RD STE B-3
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33771-3530
Practice Address - Country:US
Practice Address - Phone:727-535-9993
Practice Address - Fax:727-530-1958
Is Sole Proprietor?:No
Enumeration Date:2021-04-12
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDH12196124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist