Ellen A Sheridan, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

015148 Issued in MO

Practice address

104 Archibald Street
Kansas City, MO 64111

Phone

(816) 531-0382

Fax

(816) 531-3708

NPI assigned

Dec 11, 2006

Sex

Female

Sole proprietor

Yes

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

Interoperability endpoints

• Direct secure messaging: ellen.sheridan.1@19814.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Keith Dental Westport LLC

  • General Practice Dentistry
  • Kansas City, MO
  • NPI 1548182025
  NPD (past)
• Westport Family Dental, LLC

  • Dental Clinic/Center
  • Kansas City, MO
  • NPI 1760093892
  NPD (past)

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1932269032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 ARCHIBALD STREET",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "64111",
            "telephone_number": "816-531-0382",
            "fax_number": "816-531-3708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 ARCHIBALD STREET",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "64111",
            "telephone_number": "816-531-0382",
            "fax_number": "816-531-3708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERIDAN",
        "first_name": "ELLEN",
        "middle_name": "A",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "015148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barbara J Sheppard, ANP
• Scott I. Sher, M.D.
• Borin Sheri, FNP
• Sheridan Healthcare of Missouri Inc
• Debbie Snow Sheridan, MA
• Hilary Sheridan, MD
• Sherri Fry-Wendt PHD LLC
• Joan Marie Sherrick
• William Mark Sherrill, APRN
• Sabra Lea Sherrow, LPC

• Dentist in Kansas City, MO
• Providers in Kansas City, MO by specialty
• Dentist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2023; 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.