Provider Demographics
NPI:1811603939
Name:SHARPS, GINA (MPH, RDH, CTTS)
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:SHARPS
Suffix:
Gender:F
Credentials:MPH, RDH, CTTS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9036 GEORGE WASHINGTON HWY
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:WV
Mailing Address - Zip Code:26330-7314
Mailing Address - Country:US
Mailing Address - Phone:304-276-0572
Mailing Address - Fax:
Practice Address - Street 1:9036 GEORGE WASHINGTON HWY
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:WV
Practice Address - Zip Code:26330-7314
Practice Address - Country:US
Practice Address - Phone:304-276-0572
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-24
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist