Provider Demographics
NPI:1790719359
Name:SHARMA, PRIVEER D (DMD)
Entity Type:Individual
Prefix:DR
First Name:PRIVEER
Middle Name:D
Last Name:SHARMA
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 1:11220 ELM LN
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-0716
Mailing Address - Country:US
Mailing Address - Phone:704-541-6070
Mailing Address - Fax:704-541-9070
Practice Address - Street 1:11220 ELM LN
Practice Address - Street 2:SUITE 100
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-0715
Practice Address - Country:US
Practice Address - Phone:704-541-6070
Practice Address - Fax:704-541-9070
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC76791223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery