Provider Demographics
NPI:1790072056
Name:SHER, DEENA (DMD)
Entity Type:Individual
Prefix:DR
First Name:DEENA
Middle Name:
Last Name:SHER
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 1:29001 CEDAR RD STE 400
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:OH
Mailing Address - Zip Code:44124-4041
Mailing Address - Country:US
Mailing Address - Phone:440-684-4868
Mailing Address - Fax:440-684-4869
Practice Address - Street 1:29001 CEDAR RD STE 400
Practice Address - Street 2:
Practice Address - City:LYNDHURST
Practice Address - State:OH
Practice Address - Zip Code:44124-4041
Practice Address - Country:US
Practice Address - Phone:440-684-4868
Practice Address - Fax:440-684-4869
Is Sole Proprietor?:No
Enumeration Date:2011-07-06
Last Update Date:2019-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0252201223P0300X
MI2901020623122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty
No122300000XDental ProvidersDentistGroup - Single Specialty