Provider Demographics
NPI:1093885758
Name:MATEJA, SHARON B (DDS)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:B
Last Name:MATEJA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7365 CARNELIAN ST
Mailing Address - Street 2:SUITE 111
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-1158
Mailing Address - Country:US
Mailing Address - Phone:909-989-5959
Mailing Address - Fax:909-944-0015
Practice Address - Street 1:7365 CARNELIAN ST
Practice Address - Street 2:SUITE 111
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-1158
Practice Address - Country:US
Practice Address - Phone:909-989-5959
Practice Address - Fax:909-944-0015
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2018-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA319491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice