Individual provider Active NPI

Sarah Marie McSherry, DMD

  • Dentist
  • Fort Drum, NY
National Provider Identifier
1568957694
Registry record updated Oct 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN1858076 Issued in MA
Practice address
10590 Enduring Freedom Dr
Fort Drum, NY 13602-5503
Phone
(315) 772-5576
NPI assigned
Jul 1, 2018
Last updated
Oct 20, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN1858076 MA Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

10590 Enduring Freedom Dr
Fort Drum, NY 13602-5503

Mailing address

23615 Woodland Dr
Watertown, NY 13601-5887
Phone (617) 750-6652

Other practice location 1

23615 Woodland Dr
Watertown, NY 13601-5887
Phone (617) 750-6652

Other names 1

  • Miss Sarah Marie Detore Former name

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
DN1858076MAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Guthrie Ahc PastSince Oct 27, 2019 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1530403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571529600000",
    "number": "1568957694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23615 WOODLAND DR",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136015887",
            "telephone_number": "617-750-6652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10590 ENDURING FREEDOM DR",
            "city": "FORT DRUM",
            "state": "NY",
            "postal_code": "136025503",
            "telephone_number": "315-772-5576"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "23615 Woodland Dr",
            "address_purpose": "LOCATION",
            "city": "Watertown",
            "state": "NY",
            "postal_code": "136015887",
            "country_code": "US",
            "telephone_number": "617-750-6652",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCSHERRY",
        "first_name": "SARAH",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-01",
        "last_updated": "2019-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1858076",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARAH",
            "last_name": "DETORE",
            "middle_name": "MARIE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Drum, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 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.