Provider Demographics
NPI:1366011454
Name:SHARON SHAMOIEL DENTAL CORPORATION
Entity Type:Organization
Organization Name:SHARON SHAMOIEL DENTAL CORPORATION
Other - Org Name:SWEET TOOTH DENTAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAMOIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-379-5262
Mailing Address - Street 1:77 ROLLING OAKS DR STE 104
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91361-1012
Mailing Address - Country:US
Mailing Address - Phone:805-256-7495
Mailing Address - Fax:805-256-7495
Practice Address - Street 1:77 ROLLING OAKS DR STE 104
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91361-1012
Practice Address - Country:US
Practice Address - Phone:805-256-7495
Practice Address - Fax:805-256-7495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-22
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0112XAmbulatory Health Care FacilitiesClinic/CenterOral and Maxillofacial Surgery