Provider Demographics
NPI:1013144328
Name:SHEFFIELD, ERIN MJ (DDS)
Entity type:Individual
Prefix:DR
First Name:ERIN
Middle Name:MJ
Last Name:SHEFFIELD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 MAINE ST
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:IL
Mailing Address - Zip Code:62301-4096
Mailing Address - Country:US
Mailing Address - Phone:217-222-6550
Mailing Address - Fax:217-277-2253
Practice Address - Street 1:3915 MAINE ST STE 3
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:IL
Practice Address - Zip Code:62305-5843
Practice Address - Country:US
Practice Address - Phone:217-222-9434
Practice Address - Fax:217-222-0671
Is Sole Proprietor?:No
Enumeration Date:2009-06-12
Last Update Date:2018-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA086581223G0001X, 390200000X
IL0210028681223S0112X
IL0190315571223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program