Provider Demographics
NPI:1417012055
Name:SHERWOOD, RICHARD L (DDS)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:L
Last Name:SHERWOOD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:990 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-1828
Mailing Address - Country:US
Mailing Address - Phone:434-792-4046
Mailing Address - Fax:434-792-7200
Practice Address - Street 1:990 MAIN ST
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541-1828
Practice Address - Country:US
Practice Address - Phone:434-792-4046
Practice Address - Fax:434-792-7200
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401008007122300000X
VA04380001441223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
282862OtherBLUE CROSS BLUE SHEILD
535914OtherUNITED CONCORDIA
VAU11715Medicare UPIN