Provider Demographics
NPI:1730255100
Name:JEFFERSON, SHARON ROBINSON (DDS)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:ROBINSON
Last Name:JEFFERSON
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 1:6738 W SUNRISE BLVD
Mailing Address - Street 2:SUITE # 105
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33313-6070
Mailing Address - Country:US
Mailing Address - Phone:954-792-1857
Mailing Address - Fax:954-792-6687
Practice Address - Street 1:6738 W SUNRISE BLVD
Practice Address - Street 2:SUITE # 105
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33313-6070
Practice Address - Country:US
Practice Address - Phone:954-792-1857
Practice Address - Fax:954-792-6687
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN169111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice