Provider Demographics
NPI:1598771578
Name:SHARP, JESSICA SCOTT (DMD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:SCOTT
Last Name:SHARP
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 ARNOW DR
Mailing Address - Street 2:
Mailing Address - City:SAINT MARYS
Mailing Address - State:GA
Mailing Address - Zip Code:31558-4071
Mailing Address - Country:US
Mailing Address - Phone:912-882-2005
Mailing Address - Fax:912-882-2342
Practice Address - Street 1:206 ARNOW DR
Practice Address - Street 2:
Practice Address - City:SAINT MARYS
Practice Address - State:GA
Practice Address - Zip Code:31558-4071
Practice Address - Country:US
Practice Address - Phone:912-882-2005
Practice Address - Fax:912-882-2342
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0156161223G0001X, 1223G0001X
KS605261223G0001X
MA216111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice