MEDICARE: WENDY E SHARPE DDS

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	14308	MA
2	1223G0001X	General Practice Dentistry	14308	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	14308	OTHER	MA	MA STATE DENTAL LICENSE

General Provider Information

NPI Number	:	1942314109
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WENDY E SHARPE DDS

Provider Business Mailing Address
First Line	:	2285 NORTHAMPTON ST
Second Line	:
City	:	HOLYOKE
State	:	MA
Zip	:	01040-3447
Country	:	US
Telephone Number	:	413-534-8700
Fax Number	:

Provider Business Practice Location Address
First Line	:	338 MONTAGUE CITY RD
Second Line	:
City	:	TURNERS FALLS
State	:	MA
Zip	:	01376-1830
Country	:	US
Telephone Number	:	413-772-3748
Fax Number	:	413-774-3072

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

Provider Enumeration Date	:	08/17/2006
Last Update Date	:	02/16/2011

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