Provider Demographics
NPI:1639935190
Name:SHARMA, MOHITA (DDS)
Entity Type:Individual
Prefix:
First Name:MOHITA
Middle Name:
Last Name:SHARMA
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 1:1795 HERNDON AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-6199
Mailing Address - Country:US
Mailing Address - Phone:209-889-5416
Mailing Address - Fax:
Practice Address - Street 1:1795 HERNDON AVE STE 104
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-6199
Practice Address - Country:US
Practice Address - Phone:559-840-4330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-22
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1098921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice