Provider Demographics
NPI:1346651007
Name:SHARMA, ASHISH PRAKASH (BDS, MSD)
Entity Type:Individual
Prefix:DR
First Name:ASHISH
Middle Name:PRAKASH
Last Name:SHARMA
Suffix:
Gender:M
Credentials:BDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16201 E INDIANA AVE STE 3240
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99216-2838
Mailing Address - Country:US
Mailing Address - Phone:509-862-5880
Mailing Address - Fax:
Practice Address - Street 1:16201 E INDIANA AVE STE 3240
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-2838
Practice Address - Country:US
Practice Address - Phone:509-862-5880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-15
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN10927122300000X
TNDS0000010927204E00000X
WADE603419171223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No122300000XDental ProvidersDentist
No204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery