MEDICARE: NOBEL DENTAL,JAGAN SHARMA,DDS,LLC

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	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1407341597
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NOBEL DENTAL,JAGAN SHARMA,DDS,LLC

Provider Business Mailing Address
First Line	:	2345 CLEVELAND AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43211-1611
Country	:	US
Telephone Number	:	414-885-7777
Fax Number	:

Provider Business Practice Location Address
First Line	:	2345 CLEVELAND AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43211-1611
Country	:	US
Telephone Number	:	414-885-7777
Fax Number	:

Authorized Official
Title or Position	:	GENERAL DENTIST
Name	:	DR. JAGAN SHARMA
Credential	:	DDS
Telephone Number	:	414-885-7777

Provider Enumeration Date	:	06/29/2018
Last Update Date	:	06/29/2018

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