Provider Demographics
NPI:1225044159
Name:NELSON, SHERYL LM (DDS)
Entity type:Individual
Prefix:DR
First Name:SHERYL
Middle Name:LM
Last Name:NELSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1011 DEVONSHIRE DR STE C-1
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-5136
Mailing Address - Country:US
Mailing Address - Phone:760-846-9190
Mailing Address - Fax:760-704-8082
Practice Address - Street 1:1011 DEVONSHIRE DR STE C-1
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-5136
Practice Address - Country:US
Practice Address - Phone:760-846-9190
Practice Address - Fax:760-704-8082
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44958122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist