Carly Ann Sherod, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D14290 Issued in MN

Practice address

120 Walnut St
Winona, MN 55987-3429

Phone

(507) 454-5854

NPI assigned

Jul 9, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Walnut Street Dental, PLLC

  • General Practice Dentistry
  • Winona, MN
  • NPI 1679398143
  Authorized official Same address or phone
• Walnut Street Dental, PLLC

  • Clinic/Center
  • Winona, MN
  • NPI 1962228718
  Authorized official Same address or phone
• Lewiston Dental Care

  • General Practice Dentistry
  • Lewiston, MN
  • NPI 1801443049
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1562630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562630400000",
    "number": "1013569136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 WALNUT ST",
            "city": "WINONA",
            "state": "MN",
            "postal_code": "559873429",
            "telephone_number": "507-454-5854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 WALNUT ST",
            "city": "WINONA",
            "state": "MN",
            "postal_code": "559873429",
            "telephone_number": "507-454-5854"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "560 Debra Dr",
            "address_purpose": "LOCATION",
            "city": "Lewiston",
            "state": "MN",
            "postal_code": "559522104",
            "country_code": "US",
            "telephone_number": "507-523-1071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEROD",
        "first_name": "CARLY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-09",
        "last_updated": "2019-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D14290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Sharp, MD
• Samantha Reggi Shea, MT
• Debbie Ann Sheets, MS, RN, LICSW, CEAP
• Troy J Shelton, MD
• Charles A Shepard, MD
• Katelyn Holly Sherpe
• Cody Shimota
• Shopko Stores Operating Co LLC (ShopKo Pharmacy 057)
• Shopko Stores Operating Co. LLC (ShopKo Optical 057)
• Shoptikal LLC (Shopko Optical 4057)

• General Practice Dentistry in Winona, MN
• Providers in Winona, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.