MEDICARE: RAJESH SHARMA D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DN10632	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134212103
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAJESH SHARMA D.D.S.

Provider Business Mailing Address
First Line	:	9015 EASTERLING DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32819-4817
Country	:	US
Telephone Number	:	407-870-5004
Fax Number	:	407-870-8366

Provider Business Practice Location Address
First Line	:	809 E OAK ST
Second Line	:	SUITE 101
City	:	KISSIMMEE
State	:	FL
Zip	:	34744-5834
Country	:	US
Telephone Number	:	407-870-5004
Fax Number	:	407-870-8366

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	12/19/2012

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