Provider Demographics
NPI:1346274388
Name:KEVY, SHERWIN ALAN (DDS)
Entity type:Individual
Prefix:DR
First Name:SHERWIN
Middle Name:ALAN
Last Name:KEVY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19221 MONTGOMERY VILLAGE AVE
Mailing Address - Street 2:SUITE C-24
Mailing Address - City:MONTGOMERY VILLAGE
Mailing Address - State:MD
Mailing Address - Zip Code:20886-5022
Mailing Address - Country:US
Mailing Address - Phone:301-921-1021
Mailing Address - Fax:301-990-0642
Practice Address - Street 1:19221 MONTGOMERY VILLAGE AVE
Practice Address - Street 2:SUITE C-24
Practice Address - City:MONTGOMERY VILLAGE
Practice Address - State:MD
Practice Address - Zip Code:20886-5022
Practice Address - Country:US
Practice Address - Phone:301-921-1021
Practice Address - Fax:301-990-0642
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD8584122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist