Healthcare Provider Details

I. General information

NPI: 1124596077
Provider Name (Legal Business Name): SHERYLANNE DONNA KAY WARREN RDH, EPDH, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2018
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 SOLANO ST
CORNING CA
96021-3352
US

IV. Provider business mailing address

2952 LAZY CREEK DR
MEDFORD OR
97504-8182
US

V. Phone/Fax

Practice location:
  • Phone: 530-690-2827
  • Fax:
Mailing address:
  • Phone: 541-841-7331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberH5044
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number38250
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: