Basic Information
| Provider Information | |||||||||
| NPI: | 1013144328 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SHEFFIELD | ||||||||
| FirstName: | ERIN | ||||||||
| MiddleName: | MJ | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.D.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1025 MAINE ST | ||||||||
| Address2: | |||||||||
| City: | QUINCY | ||||||||
| State: | IL | ||||||||
| PostalCode: | 623014096 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2172226550 | ||||||||
| FaxNumber: | 2172772253 | ||||||||
| Practice Location | |||||||||
| Address1: | 3915 MAINE ST STE 3 | ||||||||
| Address2: | |||||||||
| City: | QUINCY | ||||||||
| State: | IL | ||||||||
| PostalCode: | 623055843 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2172229434 | ||||||||
| FaxNumber: | 2172220671 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/12/2009 | ||||||||
| LastUpdateDate: | 05/10/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223G0001X | 08658 | IA | N | Dental Providers | Dentist | General Practice | 1223S0112X | 021002868 | IL | N | Dental Providers | Dentist | Oral and Maxillofacial Surgery | 390200000X | 08658 | IA | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 1223S0112X | 019031557 | IL | Y | Dental Providers | Dentist | Oral and Maxillofacial Surgery |
No ID Information.