Provider Demographics
NPI:1730520461
Name:SHARMA, NIDHI
Entity type:Individual
Prefix:
First Name:NIDHI
Middle Name:
Last Name:SHARMA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 SAN MARCOS DR
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75039-3311
Mailing Address - Country:US
Mailing Address - Phone:214-406-6557
Mailing Address - Fax:
Practice Address - Street 1:2585 W IRVING BLVD
Practice Address - Street 2:STE 150
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75061-4230
Practice Address - Country:US
Practice Address - Phone:972-663-5353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-10
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0029252122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist