Provider Demographics
NPI:1295956613
Name:HARRIS, SHEILA NICOLE (DDS)
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:NICOLE
Last Name:HARRIS
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 1:2121 NATOMAS CROSSING DR STE 100
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95834-3848
Mailing Address - Country:US
Mailing Address - Phone:916-928-9999
Mailing Address - Fax:
Practice Address - Street 1:2121 NATOMAS CROSSING DR STE 100
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95834-3848
Practice Address - Country:US
Practice Address - Phone:916-928-9999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2009-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA581941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice