Provider Demographics
NPI:1851500714
Name:SHERON, CHAD RICHARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:RICHARD
Last Name:SHERON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14008 NW 53RD AVE
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98685-1590
Mailing Address - Country:US
Mailing Address - Phone:360-571-0234
Mailing Address - Fax:
Practice Address - Street 1:1200 NE 99TH ST
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98665-8909
Practice Address - Country:US
Practice Address - Phone:360-573-8181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000090231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice