Provider Demographics
NPI:1790342566
Name:SHERMAN, RICHARD K (DMD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:K
Last Name:SHERMAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8026 S BARNWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84094-7269
Mailing Address - Country:US
Mailing Address - Phone:801-946-7317
Mailing Address - Fax:
Practice Address - Street 1:7138 S HIGHLAND DR STE 214
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84121-3783
Practice Address - Country:US
Practice Address - Phone:801-942-7770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-28
Last Update Date:2019-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9070099-89031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice