Provider Demographics
NPI:1376573790
Name:LONG-STOKES, SHARON ANITA (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:ANITA
Last Name:LONG-STOKES
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:106 S MURROW BLVD
Mailing Address - Street 2:STE. 100
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-2959
Mailing Address - Country:US
Mailing Address - Phone:336-275-9922
Mailing Address - Fax:336-275-0040
Practice Address - Street 1:106 S MURROW BLVD
Practice Address - Street 2:STE. 100
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-2959
Practice Address - Country:US
Practice Address - Phone:336-275-9922
Practice Address - Fax:336-275-0040
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC64521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8995377Medicaid
NC809129OtherUNITED CONCORDIA
NC0217YOtherBCBS NC