Provider Demographics
NPI:1689926172
Name:SHARMA DDS INC.
Entity Type:Organization
Organization Name:SHARMA DDS INC.
Other - Org Name:ELITE ORTHODONTIC SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUHASINI
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARMA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:619-442-4141
Mailing Address - Street 1:810 JAMACHA RD
Mailing Address - Street 2:SUITE #205
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92019-6218
Mailing Address - Country:US
Mailing Address - Phone:619-442-4141
Mailing Address - Fax:619-442-3199
Practice Address - Street 1:810 JAMACHA RD
Practice Address - Street 2:SUITE #205
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92019-6218
Practice Address - Country:US
Practice Address - Phone:619-442-4141
Practice Address - Fax:619-442-3199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-08
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52468122300000X
1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty
No122300000XDental ProvidersDentistGroup - Single Specialty