Healthcare Provider Details

I. General information

NPI: 1255426821
Provider Name (Legal Business Name): SHARON GABRIEL DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 02/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 N VERDUGO RD STE 100
GLENDALE CA
91206-5238
US

IV. Provider business mailing address

320 N VERDUGO RD STE 100
GLENDALE CA
91206-5238
US

V. Phone/Fax

Practice location:
  • Phone: 818-548-0608
  • Fax: 818-548-0648
Mailing address:
  • Phone: 818-548-0608
  • Fax: 818-548-0648

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDT-1929
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number43338
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: