Provider Demographics
NPI:1992824437
Name:SHARP, KENNETH REED (DDS)
Entity Type:Individual
Prefix:
First Name:KENNETH
Middle Name:REED
Last Name:SHARP
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12240 CAJUN DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-4980
Mailing Address - Country:US
Mailing Address - Phone:972-658-6762
Mailing Address - Fax:
Practice Address - Street 1:2430 IH35E SOUTH
Practice Address - Street 2:SUITE 210
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76205
Practice Address - Country:US
Practice Address - Phone:940-387-2214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22427122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist