Provider Demographics
NPI:1194878082
Name:AMMONS, SHARON L I (DMD)
Entity type:Individual
Prefix:DR
First Name:SHARON
Middle Name:L
Last Name:AMMONS
Suffix:I
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3356 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-3133
Mailing Address - Country:US
Mailing Address - Phone:412-682-1373
Mailing Address - Fax:412-687-1883
Practice Address - Street 1:3356 5TH AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-3133
Practice Address - Country:US
Practice Address - Phone:412-682-1373
Practice Address - Fax:412-687-1883
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-025582-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice