Provider Demographics
NPI:1922131473
Name:COLVIN, SHARON YVETTE (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:YVETTE
Last Name:COLVIN
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 1:12025 CALICO WOODS PL
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20601-7260
Mailing Address - Country:US
Mailing Address - Phone:757-618-0519
Mailing Address - Fax:888-492-9434
Practice Address - Street 1:12025 CALICO WOODS PL
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20601-7260
Practice Address - Country:US
Practice Address - Phone:757-618-0519
Practice Address - Fax:888-492-9434
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2012-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010081331223G0001X
DCDEN10010591223G0001X
MD151591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice