Healthcare Provider Details

I. General information

NPI: 1326860578
Provider Name (Legal Business Name): ASHMITA SHARMA OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2024
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9265 E BASELINE RD STE 102
MESA AZ
85209-8312
US

IV. Provider business mailing address

9265 E BASELINE RD STE 102
MESA AZ
85209-8312
US

V. Phone/Fax

Practice location:
  • Phone: 480-354-4030
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberTA3046
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT-002923
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: