Provider Demographics
NPI:1033106414
Name:BYDONIE, SHARON LYNN (DH)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:LYNN
Last Name:BYDONIE
Suffix:
Gender:F
Credentials:DH
Other - Prefix:MS
Other - First Name:SHARON
Other - Middle Name:LYNN
Other - Last Name:BILLIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DH
Mailing Address - Street 1:PO BOX 160
Mailing Address - Street 2:
Mailing Address - City:SHIPROCK
Mailing Address - State:NM
Mailing Address - Zip Code:87420-0160
Mailing Address - Country:US
Mailing Address - Phone:505-368-6401
Mailing Address - Fax:505-368-6431
Practice Address - Street 1:US HWY 491 N
Practice Address - Street 2:
Practice Address - City:SHIPROCK
Practice Address - State:NM
Practice Address - Zip Code:87420
Practice Address - Country:US
Practice Address - Phone:505-368-6401
Practice Address - Fax:505-368-6431
Is Sole Proprietor?:No
Enumeration Date:2005-09-30
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDH1338124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist