Provider Demographics
NPI:1558749663
Name:SHARMA ACCESS DENTAL PS
Entity Type:Organization
Organization Name:SHARMA ACCESS DENTAL PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SANJEEV
Authorized Official - Middle Name:K
Authorized Official - Last Name:SHARMA
Authorized Official - Suffix:
Authorized Official - Credentials:BDS MDS MS
Authorized Official - Phone:360-921-6856
Mailing Address - Street 1:1412 NE 134TH ST
Mailing Address - Street 2:#140
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98685-2719
Mailing Address - Country:US
Mailing Address - Phone:360-573-4848
Mailing Address - Fax:360-573-6272
Practice Address - Street 1:1412 NE 134TH ST
Practice Address - Street 2:#140
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98685-2719
Practice Address - Country:US
Practice Address - Phone:360-573-4848
Practice Address - Fax:360-573-6272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-08
Last Update Date:2015-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA8301261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2034673Medicaid