Healthcare Provider Details

I. General information

NPI: 1710407630
Provider Name (Legal Business Name): ANUPAMA SHARMA DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15458 BEACH BLVD
WESTMINSTER CA
92683
US

IV. Provider business mailing address

15458 BEACH BLVD
WESTMINSTER CA
92683-6210
US

V. Phone/Fax

Practice location:
  • Phone: 714-898-3220
  • Fax:
Mailing address:
  • Phone: 714-898-3220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDDS101267
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: