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General NPI Number Information
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NPI Number | 1508130972
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Entity Type | Individual
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Provider Name | LAURA SHARBASH D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 03/02/2012
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Last Update Date | 07/12/2024
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Provider Practice Location Address
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Address Line | 26302 LA PAZ RD STE 203
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City | MISSION VIEJO
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State | CA
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Zip | 92691-5328
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Country | US
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Telephone | 949-586-5669
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Fax |
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Provider Business Mailing Address
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Address Line | 3301 MICHELSON DR APT 1519
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City | IRVINE
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State | CA
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Zip | 92612-7681
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Country | US
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Telephone | 631-838-9411
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 22DI02481500
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License Number State | NJ
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