Provider Demographics
NPI:1255401048
Name:HADLEY, SHARI ANN (DDS)
Entity type:Individual
Prefix:DR
First Name:SHARI
Middle Name:ANN
Last Name:HADLEY
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 1:2460 WILLAMETTE STREET, UPPER LEVEL
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405
Mailing Address - Country:US
Mailing Address - Phone:541-463-5206
Mailing Address - Fax:541-463-4176
Practice Address - Street 1:2460 WILLAMETTE STREET, UPPER LEVEL
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405
Practice Address - Country:US
Practice Address - Phone:541-463-5206
Practice Address - Fax:541-463-4176
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE51251223G0001X
ORD105831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORFH6699075OtherDEA LICENSE