Healthcare Provider Details

I. General information

NPI: 1861757098
Provider Name (Legal Business Name): RYAN BURR SHARP DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2012
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 W WHITE ST # 100
ANNA TX
75409-5347
US

IV. Provider business mailing address

2101 W WHITE ST # 100
ANNA TX
75409-5347
US

V. Phone/Fax

Practice location:
  • Phone: 972-924-2452
  • Fax:
Mailing address:
  • Phone: 972-924-2452
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number28036
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: