Active NPI
Olivia Sheridan, DMD
- General Practice Dentistry
- Philadelphia, PA
National Provider Identifier
1205098233
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DS027388L
- Practice address
- 240 South 40TH Street
University of Pennsylvania School of Dental Medicine
Philadelphia, PA 19105 - Phone
- (215) 898-4615
- NPI assigned
- Jul 1, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DS027388L | PA | Primary |
Addresses
Primary practice location
240 South 40TH Street
University of Pennsylvania School of Dental Medicine
Philadelphia, PA 19105
Mailing address
240 South 40TH Street
University of Pennsylvania School of Dental Medicine
Philadelphia, PA 19104
Phone (215) 898-4615
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
| License | State | Type | Specialty |
|---|---|---|---|
| DS027388L | PA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214870400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214870400000",
"number": "1205098233",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "240 SOUTH 40TH STREET",
"address_2": "UNIVERSITY OF PENNSYLVANIA SCHOOL OF DENTAL MEDICINE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "19104",
"telephone_number": "215-898-4615"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "240 SOUTH 40TH STREET",
"address_2": "UNIVERSITY OF PENNSYLVANIA SCHOOL OF DENTAL MEDICINE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "19105",
"telephone_number": "215-898-4615"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHERIDAN",
"first_name": "OLIVIA",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-07-01",
"last_updated": "2008-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "PA",
"license": "DS027388L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.