Individual provider Active NPI

David John Sherrard, DDS

  • General Practice Dentistry
  • Davenport, IA
National Provider Identifier
1407914385
Registry record updated Aug 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
09621 Issued in IA
Practice address
5270 Elmore Ave
Davenport, IA 52807-3437
Phone
(563) 209-9000
NPI assigned
Dec 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7505 WA
General Practice Dentistry 1223G0001X 4862 AZ
General Practice Dentistry 1223G0001X 1002237 WI
General Practice Dentistry 1223G0001X 09621 IA Primary

Addresses

Primary practice location

5270 Elmore Ave
Davenport, IA 52807-3437

Mailing address

2366 39TH St
Rock Island, IL 61201-5143
Phone (253) 921-4770

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL ApenDental Direct

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
4862AZMDGeneral Practice Dentistry
09621IAMDGeneral Practice Dentistry
7505WAMDGeneral Practice Dentistry
1002237WIMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630022400000",
    "number": "1407914385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2366 39TH ST",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612015143",
            "telephone_number": "253-921-4770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5270 ELMORE AVE",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528073437",
            "telephone_number": "563-209-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERRARD",
        "first_name": "DAVID",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "7505",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "4862",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "1002237",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "09621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "ApenDental",
            "affiliation": "N",
            "endpointDescription": "DentalOffice",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5270 Elmore Ave",
            "city": "Davenport",
            "state": "IA",
            "country_code": "US",
            "postal_code": "528073437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Davenport, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2021; 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.