Provider Demographics
NPI:1629715701
Name:SHARON, SHAY SHMUEL YOSEF (DMD)
Entity Type:Individual
Prefix:
First Name:SHAY
Middle Name:SHMUEL YOSEF
Last Name:SHARON
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:SHMUEL NATAN IU APT. 3
Mailing Address - Street 2:
Mailing Address - City:JERUSALEM
Mailing Address - State:JERUSALEM
Mailing Address - Zip Code:9641207
Mailing Address - Country:IL
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:ORAL AND MAXILLOFACIAL SURGERY DEPARTMENT, BOSTON MEDIC
Practice Address - Street 2:635 ALBANY ST BOSTON UNIVERSITY SCHOOL OF DENTAL MEDICI
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118
Practice Address - Country:US
Practice Address - Phone:617-414-7558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-19
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program