Provider Demographics
NPI:1164583209
Name:SHARMA & DEST, DDS, PA
Entity Type:Organization
Organization Name:SHARMA & DEST, DDS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:F
Authorized Official - Last Name:DEST
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:704-547-1279
Mailing Address - Street 1:8305 UNIVERSITY EXECUTIVE PARK
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262
Mailing Address - Country:US
Mailing Address - Phone:704-547-1279
Mailing Address - Fax:704-547-8383
Practice Address - Street 1:1525 W WT HARRIS BLVD
Practice Address - Street 2:SUITE 1ANC5903
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28288-0001
Practice Address - Country:US
Practice Address - Phone:704-427-0277
Practice Address - Fax:704-427-0484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC52831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty