Provider Demographics
NPI:1366174385
Name:KLEEFISCH, ELIZABETH JANE SHERMAN (DDS, MSD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:JANE SHERMAN
Last Name:KLEEFISCH
Suffix:
Gender:F
Credentials:DDS, MSD
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Mailing Address - Street 1:923 PRESTIGE CT
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23602-9437
Mailing Address - Country:US
Mailing Address - Phone:225-226-8561
Mailing Address - Fax:
Practice Address - Street 1:220 NAT TURNER BLVD S
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-2998
Practice Address - Country:US
Practice Address - Phone:757-240-5711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-28
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA04014188121223P0221X
LA73171223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry