Provider Demographics
NPI:1992959910
Name:PADGETT, SHERRY L (DMD)
Entity type:Individual
Prefix:DR
First Name:SHERRY
Middle Name:L
Last Name:PADGETT
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:SHERRY
Other - Middle Name:L
Other - Last Name:YOUNGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:500 STEVENS ENTRY
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-6711
Mailing Address - Country:US
Mailing Address - Phone:770-487-5327
Mailing Address - Fax:770-487-7835
Practice Address - Street 1:500 STEVENS ENTRY
Practice Address - Street 2:
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-6711
Practice Address - Country:US
Practice Address - Phone:770-487-5327
Practice Address - Fax:770-487-7835
Is Sole Proprietor?:No
Enumeration Date:2008-11-05
Last Update Date:2010-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0127891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice