Provider Demographics
NPI:1821385634
Name:SHERROD, ASHLEY MARIE (DDS)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:MARIE
Last Name:SHERROD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:ASHLEY
Other - Middle Name:MARIE
Other - Last Name:MCDONALD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:1705 FORT BRAGG RD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28303-6801
Mailing Address - Country:US
Mailing Address - Phone:479-719-2910
Mailing Address - Fax:
Practice Address - Street 1:2997 HOPE MILLS RD STE C
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28306-8349
Practice Address - Country:US
Practice Address - Phone:104-260-8009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-30
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR38311223G0001X
NC111071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice