Provider Demographics
NPI:1588119416
Name:VERMA, SEAN (DMD)
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:VERMA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 S CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:NEW CARLISLE
Mailing Address - State:OH
Mailing Address - Zip Code:45344-1903
Mailing Address - Country:US
Mailing Address - Phone:937-845-0038
Mailing Address - Fax:
Practice Address - Street 1:103 S CHURCH ST
Practice Address - Street 2:
Practice Address - City:NEW CARLISLE
Practice Address - State:OH
Practice Address - Zip Code:45344-1903
Practice Address - Country:US
Practice Address - Phone:937-845-0038
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-21
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRES.37741223G0001X
OH30.0249501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0191036Medicaid