Provider Demographics
NPI:1245355809
Name:STERN, CHERYL R (DDS)
Entity type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:R
Last Name:STERN
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 1:24300 CHAGRIN BLVD
Mailing Address - Street 2:SUITE 111
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5639
Mailing Address - Country:US
Mailing Address - Phone:216-514-9440
Mailing Address - Fax:216-514-9450
Practice Address - Street 1:24300 CHAGRIN BLVD
Practice Address - Street 2:SUITE 111
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5639
Practice Address - Country:US
Practice Address - Phone:216-514-9440
Practice Address - Fax:216-514-9450
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-0175501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0897669Medicaid