Provider Demographics
NPI:1427364041
Name:MILLER, SHARA MARI (DDS)
Entity Type:Individual
Prefix:
First Name:SHARA
Middle Name:MARI
Last Name:MILLER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 E 22ND ST
Mailing Address - Street 2:7B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-5703
Mailing Address - Country:US
Mailing Address - Phone:646-483-1401
Mailing Address - Fax:
Practice Address - Street 1:320 E 22ND ST
Practice Address - Street 2:7B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-5703
Practice Address - Country:US
Practice Address - Phone:646-483-1401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-19
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY055088-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist