Provider Demographics
NPI:1942347943
Name:TSO, SHARON K (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:K
Last Name:TSO
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 1:20439 SHERMAN WAY
Mailing Address - Street 2:
Mailing Address - City:WINNETKA
Mailing Address - State:CA
Mailing Address - Zip Code:91306-3109
Mailing Address - Country:US
Mailing Address - Phone:818-883-3922
Mailing Address - Fax:818-883-3923
Practice Address - Street 1:20439 SHERMAN WAY
Practice Address - Street 2:
Practice Address - City:WINNETKA
Practice Address - State:CA
Practice Address - Zip Code:91306-3109
Practice Address - Country:US
Practice Address - Phone:818-883-3922
Practice Address - Fax:818-883-3923
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA317221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice