Provider Demographics
NPI:1942314109
Name:SHARPE, WENDY E (DDS)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:E
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 1:2285 NORTHAMPTON ST
Mailing Address - Street 2:
Mailing Address - City:HOLYOKE
Mailing Address - State:MA
Mailing Address - Zip Code:01040-3447
Mailing Address - Country:US
Mailing Address - Phone:413-534-8700
Mailing Address - Fax:
Practice Address - Street 1:338 MONTAGUE CITY RD
Practice Address - Street 2:
Practice Address - City:TURNERS FALLS
Practice Address - State:MA
Practice Address - Zip Code:01376-1830
Practice Address - Country:US
Practice Address - Phone:413-772-3748
Practice Address - Fax:413-774-3072
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA143081223X0400X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA14308OtherMA STATE DENTAL LICENSE