Provider Demographics
NPI:1679882021
Name:MCINTOSH, SHERI (DDS)
Entity type:Individual
Prefix:DR
First Name:SHERI
Middle Name:
Last Name:MCINTOSH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:SHERI
Other - Middle Name:
Other - Last Name:MCCONNELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:3112 CEDARPOINT DR
Mailing Address - Street 2:
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-6330
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4901 GOLDEN TRIANGLE BLVD STE 111
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-4483
Practice Address - Country:US
Practice Address - Phone:817-337-8300
Practice Address - Fax:817-337-8322
Is Sole Proprietor?:No
Enumeration Date:2010-10-04
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21766122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist