Healthcare Provider Details

I. General information

NPI: 1912569179
Provider Name (Legal Business Name): VIBHUTI SHARMA DMD, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SIMRAN SHARMA DMD, MS

II. Dates (important events)

Enumeration Date: 07/08/2019
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5126 25TH AVE NE
SEATTLE WA
98105-4121
US

IV. Provider business mailing address

5126 25TH AVE NE
SEATTLE WA
98105-4121
US

V. Phone/Fax

Practice location:
  • Phone: 206-523-6520
  • Fax: 206-523-8080
Mailing address:
  • Phone: 206-523-6520
  • Fax: 206-523-8080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDE60956361
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: