Provider Demographics
NPI:1225030125
Name:VERDINELLI, SHARON M (DMD, FAGD)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:M
Last Name:VERDINELLI
Suffix:
Gender:F
Credentials:DMD, FAGD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1165 MANTUA PIKE
Mailing Address - Street 2:
Mailing Address - City:MANTUA
Mailing Address - State:NJ
Mailing Address - Zip Code:08051-1649
Mailing Address - Country:US
Mailing Address - Phone:856-464-1141
Mailing Address - Fax:856-464-1223
Practice Address - Street 1:1165 MANTUA PIKE
Practice Address - Street 2:
Practice Address - City:MANTUA
Practice Address - State:NJ
Practice Address - Zip Code:08051-1649
Practice Address - Country:US
Practice Address - Phone:856-464-1141
Practice Address - Fax:856-464-1223
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ177531223G0001X
PADS027413L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice