Provider Demographics
NPI:1356717656
Name:TED SHERWIN, DDS, PC
Entity type:Organization
Organization Name:TED SHERWIN, DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TED
Authorized Official - Middle Name:
Authorized Official - Last Name:SHERWIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-672-2605
Mailing Address - Street 1:111D SPICERS MILL RD
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:VA
Mailing Address - Zip Code:22960-1023
Mailing Address - Country:US
Mailing Address - Phone:540-672-2605
Mailing Address - Fax:540-672-0241
Practice Address - Street 1:111D SPICERS MILL RD
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:VA
Practice Address - Zip Code:22960-1023
Practice Address - Country:US
Practice Address - Phone:540-672-2605
Practice Address - Fax:540-672-0241
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-20
Last Update Date:2015-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401006357122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty