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General NPI Number Information
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NPI Number | 1174969190
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Entity Type | Individual
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Provider Name | JASON WAYNE SHERRELL DMD
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Gender | Male
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Dates
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Enumeration Date | 05/16/2013
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Last Update Date | 03/03/2026
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Provider Practice Location Address
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Address Line | 9002 SIX PINES DR SUITE #142
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City | SHENANDOAH
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State | TX
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Zip | 77380
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Country | US
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Telephone | 814-935-0251
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Fax | 832-558-1177
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Provider Business Mailing Address
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Address Line | 9002 SIX PINES DR SUITE #142
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City | SHENANDOAH
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State | TX
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Zip | 77380
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Country | US
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Telephone | 214-417-7188
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Fax | 832-558-1177
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 28813
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223D0004X
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Taxonomy Name | Dental Anesthesiology
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License Number | 28813
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License Number State | TX
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