Provider Demographics
NPI:1346242468
Name:SHENKER, KERI ALLISON (DMD)
Entity type:Individual
Prefix:DR
First Name:KERI
Middle Name:ALLISON
Last Name:SHENKER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 N UNIVERSITY DR
Mailing Address - Street 2:SUITE 108
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-2039
Mailing Address - Country:US
Mailing Address - Phone:954-530-7308
Mailing Address - Fax:954-530-7409
Practice Address - Street 1:201 N UNIVERSITY DR
Practice Address - Street 2:SUITE 108
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-2039
Practice Address - Country:US
Practice Address - Phone:954-530-7308
Practice Address - Fax:954-530-7409
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-01
Last Update Date:2010-02-23
Deactivation Date:2006-03-21
Deactivation Code:
Reactivation Date:2006-03-27
Provider Licenses
StateLicense IDTaxonomies
FLDN164441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice