Provider Demographics
NPI:1194107565
Name:HE, SHENYE (DMD)
Entity type:Individual
Prefix:
First Name:SHENYE
Middle Name:
Last Name:HE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:SHERRY
Other - Middle Name:
Other - Last Name:HE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:600 TEXAS ST
Mailing Address - Street 2:SUITE #C
Mailing Address - City:CLOVIS
Mailing Address - State:NM
Mailing Address - Zip Code:88101-9410
Mailing Address - Country:US
Mailing Address - Phone:575-762-1900
Mailing Address - Fax:
Practice Address - Street 1:600 TEXAS ST
Practice Address - Street 2:SUITE #C
Practice Address - City:CLOVIS
Practice Address - State:NM
Practice Address - Zip Code:88101-9410
Practice Address - Country:US
Practice Address - Phone:575-762-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-22
Last Update Date:2015-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD43201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice