=====================================================
General NPI Number Information
=====================================================
NPI Number | 1912221029
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SHARON H ORNSTEIN, DDS, PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/18/2010
-----------------------------------------------------
Last Update Date | 03/18/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6351 N PRESTON RD SUITE 200
-----------------------------------------------------
City | FISCO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75034
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-712-5035
-----------------------------------------------------
Fax | 972-712-8574
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10 MEDICAL PKWY SUITE 101
-----------------------------------------------------
City | DALLAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75234
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-243-5035
-----------------------------------------------------
Fax | 972-243-8574
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/PHYSISIAN
-----------------------------------------------------
Name | SHARON H ORNSTEIN
-----------------------------------------------------
Credential | DDS
-----------------------------------------------------
Telephone | 972-243-5035
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QS0112X
-----------------------------------------------------
Taxonomy Name | Oral and Maxillofacial Surgery Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------