Individual provider Active NPI

Jason Wayne Sherrell, DMD

  • Dentist
  • Shenandoah, TX
National Provider Identifier
1174969190
Registry record updated Mar 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
28813 Issued in TX
Practice address
9002 Six Pines Dr
Suite #142
Shenandoah, TX 77380
Phone
(814) 935-0251
Fax
(832) 558-1177
NPI assigned
May 16, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 28813 TX Primary
Dental Anesthesiology 1223D0004X 28813 TX

Addresses

Primary practice location

9002 Six Pines Dr
Suite #142
Shenandoah, TX 77380

Mailing address

9002 Six Pines Dr
Suite #142
Shenandoah, TX 77380
Phone (214) 417-7188

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
28813TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Alternatives, PLLC Dentist Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1368662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772496000000",
    "number": "1174969190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9002 SIX PINES DR",
            "address_2": "SUITE #142",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "77380",
            "telephone_number": "214-417-7188",
            "fax_number": "832-558-1177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9002 SIX PINES DR",
            "address_2": "SUITE #142",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "77380",
            "telephone_number": "814-935-0251",
            "fax_number": "832-558-1177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERRELL",
        "first_name": "JASON",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-16",
        "last_updated": "2026-03-03",
        "certification_date": "2026-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "28813",
            "primary": true
        },
        {
            "code": "1223D0004X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Anesthesiology",
            "state": "TX",
            "license": "28813",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shenandoah, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2026; 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.