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General NPI Number Information
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NPI Number | 1982956579
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Entity Type | Organization
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Legal Business Name | SHARMA DDS INC.
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Dates
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Enumeration Date | 10/08/2012
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Last Update Date | 06/29/2022
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Provider Practice Location Address
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Address Line | 3001 BONITA RD STE 400
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City | CHULA VISTA
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State | CA
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Zip | 91910-3243
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Country | US
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Telephone | 619-425-1554
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Fax | 619-425-1557
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Provider Business Mailing Address
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Address Line | 3001 BONITA RD SUITE #400
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City | CHULA VISTA
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State | CA
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Zip | 91910-3224
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Country | US
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Telephone | 619-425-1554
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Fax | 619-425-1557
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SUHASINI SHARMA
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Credential | DDS
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Telephone | 619-425-1554
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 52468
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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