Douglas Sherly

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DI21527 Issued in NJ

Practice address

326 Haddon Ave
Haddon Township, NJ 08108-2825

Phone

(856) 854-0146

NPI assigned

Dec 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Braden Dental of South Jersey PC

  dba Dentistry of South Jersey-Westmont

  • General Practice Dentistry
  • Haddon Township, NJ
  • NPI 1225883077
  Authorized official Same address or phone
• Braden Dental of South Jersey PC

  dba Dentistry of South Jersey-Pennsville

  • General Practice Dentistry
  • Pennsville, NJ
  • NPI 1619722469
  NPD (past) Authorized official
• Braden Dental of South Jersey PC

  dba Dentistry of South Jersey - West Deptford

  • General Practice Dentistry
  • West Deptford, NJ
  • NPI 1700046216
  NPD (past) Authorized official

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544400000000",
    "number": "1811059033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 HADDON AVE",
            "city": "HADDON TOWNSHIP",
            "state": "NJ",
            "postal_code": "081082825",
            "telephone_number": "856-854-0146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 HADDON AVE",
            "city": "HADDON TOWNSHIP",
            "state": "NJ",
            "postal_code": "081082825",
            "telephone_number": "856-854-0146"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "526 S Burnt Mill Rd",
            "address_purpose": "LOCATION",
            "city": "Voorhees",
            "state": "NJ",
            "postal_code": "080432205",
            "country_code": "US",
            "telephone_number": "856-795-5565",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHERLY",
        "first_name": "DOUGLAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2018-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "DI21527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Rose, MA, LAC
• Stephanie Ross-Copes, LPN,CPC-I,LADC
• George Towers Rowland III, PT, OCS, CERT.MDT
• Veda Saunders-Walters
• Rebecca Sheehan, M.A. CCC/SLP
• Brendan A Sheskier, PHARMD
• Rose Marie Silicato, PAC
• Scott A Silver, DMD
• Neal S Slutsky, D.M.D.
• Kristin N Smith

• General Practice Dentistry in Haddon Township, NJ
• Providers in Haddon Township, NJ by specialty
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2018; 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.