Healthcare Provider Details

I. General information

NPI: 1295999381
Provider Name (Legal Business Name): SABRY M SHARARA D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2008
Last Update Date: 07/30/2025
Certification Date: 07/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2436 MOUNDS VIEW BLVD STE 110
SAINT PAUL MN
55112-1482
US

IV. Provider business mailing address

2436 MOUNDS VIEW BLVD STE 110
SAINT PAUL MN
55112-1482
US

V. Phone/Fax

Practice location:
  • Phone: 763-432-3399
  • Fax: 763-432-3541
Mailing address:
  • Phone: 763-432-3399
  • Fax: 763-432-3541

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberD12183
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: