Individual provider Active NPI

John Theodore Sherwin, DDS

  • Dentist
  • Orange, VA
National Provider Identifier
1790865848
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6357 Issued in VA
Practice address
462 N Madison Road
Orange, VA 22960
Phone
(540) 672-2605
Fax
(540) 672-0241
NPI assigned
Oct 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6357 VA Primary

Addresses

Primary practice location

462 N Madison Road
Orange, VA 22960

Mailing address

462 N Madison Road
Orange, VA 22960
Phone (540) 672-2605

Other identifiers 1

IdentifierTypeStateIssuer
7822618MedicaidVA

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
6357VAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790865848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "462 N MADISON ROAD",
            "city": "ORANGE",
            "state": "VA",
            "postal_code": "22960",
            "telephone_number": "540-672-2605",
            "fax_number": "540-672-0241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "462 N MADISON ROAD",
            "city": "ORANGE",
            "state": "VA",
            "postal_code": "22960",
            "telephone_number": "540-672-2605",
            "fax_number": "540-672-0241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERWIN",
        "first_name": "JOHN",
        "middle_name": "THEODORE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "6357",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7822618",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.