Provider Demographics
NPI:1952386625
Name:SHARMA, RENU YADAV (DDS)
Entity Type:Individual
Prefix:DR
First Name:RENU
Middle Name:YADAV
Last Name:SHARMA
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 1:331 CRESTLAKE DR
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94132-1320
Mailing Address - Country:US
Mailing Address - Phone:707-562-8236
Mailing Address - Fax:
Practice Address - Street 1:VA NCHCS- DENTAL SERVICE
Practice Address - Street 2:BLDG 201 WALNUT AVE
Practice Address - City:MARE ISLAND
Practice Address - State:CA
Practice Address - Zip Code:94592
Practice Address - Country:US
Practice Address - Phone:707-562-8236
Practice Address - Fax:707-562-8247
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38476122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist