Provider Demographics
NPI:1437672243
Name:JOHN, SHERIN ANNA (DDS)
Entity Type:Individual
Prefix:
First Name:SHERIN
Middle Name:ANNA
Last Name:JOHN
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 1:35456 EDGETON CT APT 305
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48335-2444
Mailing Address - Country:US
Mailing Address - Phone:248-679-2057
Mailing Address - Fax:
Practice Address - Street 1:21427 GRAND RIVER AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48219-3896
Practice Address - Country:US
Practice Address - Phone:313-412-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-24
Last Update Date:2017-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901022412122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist