Provider Demographics
NPI:1760895874
Name:SHARPE, BETHANY JOSEPH (DDS)
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:JOSEPH
Last Name:SHARPE
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 1:105 OVILLA CREEK CT STE 200
Mailing Address - Street 2:
Mailing Address - City:OVILLA
Mailing Address - State:TX
Mailing Address - Zip Code:75154-1816
Mailing Address - Country:US
Mailing Address - Phone:972-223-0313
Mailing Address - Fax:214-389-0101
Practice Address - Street 1:105 OVILLA CREEK CT STE 200
Practice Address - Street 2:
Practice Address - City:OVILLA
Practice Address - State:TX
Practice Address - Zip Code:75154-1816
Practice Address - Country:US
Practice Address - Phone:972-223-0313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-05
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX300731223G0001X
LA64891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice