Provider Demographics
NPI:1255569026
Name:YUSUF, SHEERIN H (DMD)
Entity type:Individual
Prefix:
First Name:SHEERIN
Middle Name:H
Last Name:YUSUF
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1630 PLEASANT HILL RD
Mailing Address - Street 2:200
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-5899
Mailing Address - Country:US
Mailing Address - Phone:248-854-3386
Mailing Address - Fax:
Practice Address - Street 1:1630 PLEASANT HILL RD
Practice Address - Street 2:200
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-5899
Practice Address - Country:US
Practice Address - Phone:248-854-3386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-30
Last Update Date:2018-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS037859122300000X
GADN0143531223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No122300000XDental ProvidersDentist