Provider Demographics
NPI:1427223957
Name:SHAMOIEL, SHARON (DMD)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:
Last Name:SHAMOIEL
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 1:16510 JAMAICA AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-4918
Mailing Address - Country:US
Mailing Address - Phone:718-206-4088
Mailing Address - Fax:
Practice Address - Street 1:16510 JAMAICA AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-4918
Practice Address - Country:US
Practice Address - Phone:718-206-4088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-25
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053289122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist