Healthcare Provider Details
I. General information
NPI: 1174537468
Provider Name (Legal Business Name): THOMAS D. SHARPLES, DDS, MS, APC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/29/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1315 ALHAMBRA BLVD SUITE 340
SACRAMENTO CA
95816-5244
US
IV. Provider business mailing address
1315 ALHAMBRA BLVD SUITE 340
SACRAMENTO CA
95816-5244
US
V. Phone/Fax
- Phone: 916-736-3101
- Fax: 916-736-3075
- Phone: 916-736-3101
- Fax: 916-736-3075
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223E0200X |
| Taxonomy | Endodontics |
| License Number | 20045 |
| License Number State | CA |
VIII. Authorized Official
Name: DR.
THOMAS
D.
SHARPLES
Title or Position: PRESIDENT
Credential: D.D.S.
Phone: 916-736-3101