Provider Demographics
NPI:1275028870
Name:SHARMA, VIKRAM (DMD)
Entity Type:Individual
Prefix:DR
First Name:VIKRAM
Middle Name:
Last Name:SHARMA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1194 E. NICHOLS RD
Mailing Address - Street 2:UNIT 2A
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60074
Mailing Address - Country:US
Mailing Address - Phone:224-587-7270
Mailing Address - Fax:
Practice Address - Street 1:444 PROSPECT AVE STE 2
Practice Address - Street 2:
Practice Address - City:MUNDELEIN
Practice Address - State:IL
Practice Address - Zip Code:60060-1963
Practice Address - Country:US
Practice Address - Phone:847-566-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-26
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019031823122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist