Provider Demographics
NPI:1396837068
Name:RAGHUBAR, SHARON A (DDS)
Entity type:Individual
Prefix:DR
First Name:SHARON
Middle Name:A
Last Name:RAGHUBAR
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:NAB LITTLE CREEK
Mailing Address - Street 2:1035 NIDER BLVD. SUITE 200
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23521
Mailing Address - Country:US
Mailing Address - Phone:757-953-8320
Mailing Address - Fax:
Practice Address - Street 1:NAB LITTLE CREEK
Practice Address - Street 2:1035 NIDER BLVD. SUITE 200
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23521
Practice Address - Country:US
Practice Address - Phone:757-953-8320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2007-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047516122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist