Provider Demographics
NPI:1457790586
Name:MANAOIS, SHARON AGSAO (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:AGSAO
Last Name:MANAOIS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:SHARON
Other - Middle Name:BRUNO
Other - Last Name:AGSAO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:8942 GLACIER POINT DR
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95212-3467
Mailing Address - Country:US
Mailing Address - Phone:209-406-2606
Mailing Address - Fax:
Practice Address - Street 1:756 PORTER AVE STE 100
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-4233
Practice Address - Country:US
Practice Address - Phone:209-451-4123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-21
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA62046122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist