Provider Demographics
NPI:1982782140
Name:SHERRY, DONNA CATHERINE (DDS)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:CATHERINE
Last Name:SHERRY
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 1:22 WHITE ST
Mailing Address - Street 2:FIRST FLOOR FRONT
Mailing Address - City:COHOES
Mailing Address - State:NY
Mailing Address - Zip Code:12047-3020
Mailing Address - Country:US
Mailing Address - Phone:518-237-2207
Mailing Address - Fax:518-237-2207
Practice Address - Street 1:22 WHITE ST
Practice Address - Street 2:FIRST FLOOR FRONT
Practice Address - City:COHOES
Practice Address - State:NY
Practice Address - Zip Code:12047-3020
Practice Address - Country:US
Practice Address - Phone:518-237-2207
Practice Address - Fax:518-237-2207
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047987122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02272815Medicaid