Provider Demographics
NPI:1427094721
Name:JAY, HEIDI SHERMAN (DDS)
Entity type:Individual
Prefix:DR
First Name:HEIDI
Middle Name:SHERMAN
Last Name:JAY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:HEIDI
Other - Middle Name:A
Other - Last Name:SHERMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:106 MCLAUGHLIN ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:24450-2023
Mailing Address - Country:US
Mailing Address - Phone:540-464-3700
Mailing Address - Fax:540-463-4990
Practice Address - Street 1:106 MCLAUGHLIN ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:VA
Practice Address - Zip Code:24450-2023
Practice Address - Country:US
Practice Address - Phone:540-464-3700
Practice Address - Fax:540-463-4990
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2015-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010079551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice