Healthcare Provider Details

I. General information

NPI: 1902749005
Provider Name (Legal Business Name): SHARP SMILES ORTHODONTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1275 E 1ST AVE UNIT A
BROOMFIELD CO
80020-3783
US

IV. Provider business mailing address

3402 GRIZZLY PEAK DR
BROOMFIELD CO
80023-8397
US

V. Phone/Fax

Practice location:
  • Phone: 213-440-0483
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: IRINA SHARP
Title or Position: ORTHODONTIST
Credential: DMD, MSD
Phone: 213-440-0483