Provider Demographics
NPI:1568758936
Name:SHEPPARD, SARA CATHERINE (DMD)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:CATHERINE
Last Name:SHEPPARD
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:183 COUNTY RD 12
Mailing Address - Street 2:SUITE 500
Mailing Address - City:ODENVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35120
Mailing Address - Country:US
Mailing Address - Phone:205-629-3099
Mailing Address - Fax:205-629-3007
Practice Address - Street 1:183 COUNTY ROAD 12
Practice Address - Street 2:SUITE 500
Practice Address - City:ODENVILLE
Practice Address - State:AL
Practice Address - Zip Code:35120
Practice Address - Country:US
Practice Address - Phone:205-629-3099
Practice Address - Fax:205-629-3007
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-23
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5846 C11223G0001X
AL5846C11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice