Provider Demographics
NPI:1366928038
Name:MCCORMACK, SHERI (DDS)
Entity type:Individual
Prefix:DR
First Name:SHERI
Middle Name:
Last Name:MCCORMACK
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7900 TRIAD CENTER DR STE 350
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27409-9086
Mailing Address - Country:US
Mailing Address - Phone:336-497-3740
Mailing Address - Fax:
Practice Address - Street 1:1030 S MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284-8183
Practice Address - Country:US
Practice Address - Phone:336-497-3740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-16
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901022581390200000X
NC11346122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program