Provider Demographics
NPI:1871507202
Name:SHARIFA H WINBUSH DDS PC
Entity Type:Organization
Organization Name:SHARIFA H WINBUSH DDS PC
Other - Org Name:THE SMILE FACTORY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARIFA
Authorized Official - Middle Name:HASIN
Authorized Official - Last Name:WINBUSH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:901-266-0555
Mailing Address - Street 1:2845 N HOUSTON LEVEE RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38016-0179
Mailing Address - Country:US
Mailing Address - Phone:901-266-0555
Mailing Address - Fax:901-266-3921
Practice Address - Street 1:2845 N HOUSTON LEVEE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38016-0179
Practice Address - Country:US
Practice Address - Phone:901-266-0555
Practice Address - Fax:901-266-3921
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS80751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty