Provider Demographics
NPI:1790307064
Name:MILLER, SHARI B (DDS)
Entity type:Individual
Prefix:DR
First Name:SHARI
Middle Name:B
Last Name:MILLER
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 1:92 RECTOR CT
Mailing Address - Street 2:
Mailing Address - City:BERGENFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07621-4221
Mailing Address - Country:US
Mailing Address - Phone:201-615-5381
Mailing Address - Fax:
Practice Address - Street 1:92 RECTOR CT
Practice Address - Street 2:
Practice Address - City:BERGENFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07621-4221
Practice Address - Country:US
Practice Address - Phone:201-615-5381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-10
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI029242001223X0400X
NY061908-011223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics