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General NPI Number Information
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NPI Number | 1386102671
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Entity Type | Individual
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Provider Name | SHERIN MERCHANT
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Gender | Female
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Dates
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Enumeration Date | 03/06/2019
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Last Update Date | 07/14/2022
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Provider Practice Location Address
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Address Line | 511 W TALCOTT RD
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City | PARK RIDGE
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State | IL
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Zip | 60068-5338
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Country | US
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Telephone | 407-970-1926
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Fax |
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Provider Business Mailing Address
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Address Line | 1430 JOHN WESLEY GILBERT DRIVE
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City | AUGUSTA
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State | GA
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Zip | 30912-2493
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Country | US
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Telephone | 407-970-1926
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Fax |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 24704
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 9563
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 019.033502
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License Number State | IL
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