Provider Demographics
NPI:1396575379
Name:LAURA SHARBASH, DDS, INC
Entity type:Organization
Organization Name:LAURA SHARBASH, DDS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARBASH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:949-760-9212
Mailing Address - Street 1:1441 AVOCADO AVE STE 606
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-7707
Mailing Address - Country:US
Mailing Address - Phone:949-760-9212
Mailing Address - Fax:
Practice Address - Street 1:1441 AVOCADO AVE STE 606
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-7707
Practice Address - Country:US
Practice Address - Phone:949-760-9212
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental