Provider Demographics
NPI:1235905969
Name:SHAREH, ZOHRAH
Entity Type:Individual
Prefix:
First Name:ZOHRAH
Middle Name:
Last Name:SHAREH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 FARVIEW DR
Mailing Address - Street 2:
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-4705
Mailing Address - Country:US
Mailing Address - Phone:862-242-6605
Mailing Address - Fax:
Practice Address - Street 1:3509 HELLER DR
Practice Address - Street 2:
Practice Address - City:STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18360-7460
Practice Address - Country:US
Practice Address - Phone:570-424-6607
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-04
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS044393122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist