Provider Demographics
NPI:1255750576
Name:SORENSEN, SHARON JENNIFER (DDS)
Entity type:Individual
Prefix:DR
First Name:SHARON
Middle Name:JENNIFER
Last Name:SORENSEN
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 1:2108 N KARLOV AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60639-3716
Mailing Address - Country:US
Mailing Address - Phone:716-866-1760
Mailing Address - Fax:
Practice Address - Street 1:3855 W NORTH AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-4640
Practice Address - Country:US
Practice Address - Phone:773-782-8900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-15
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019029686122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist