Provider Demographics
NPI:1659800654
Name:SHERIDAN, SYDNEY JEAN REDMOND (DDS)
Entity Type:Individual
Prefix:MRS
First Name:SYDNEY
Middle Name:JEAN REDMOND
Last Name:SHERIDAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:SYDNEY
Other - Middle Name:JEAN
Other - Last Name:REDMOND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1017 ROSS AVE
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79605-3240
Mailing Address - Country:US
Mailing Address - Phone:701-371-1406
Mailing Address - Fax:
Practice Address - Street 1:7MDG DYESS 697 LOUISIANA DRIVE
Practice Address - Street 2:
Practice Address - City:DYESS
Practice Address - State:TX
Practice Address - Zip Code:79607-1367
Practice Address - Country:US
Practice Address - Phone:325-696-2304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-05
Last Update Date:2018-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND13841122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist