Provider Demographics
NPI:1215612478
Name:SHARMA, VASU
Entity type:Individual
Prefix:
First Name:VASU
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 1:257 JONES ROAD
Mailing Address - Street 2:
Mailing Address - City:STONEYCREEK
Mailing Address - State:ON
Mailing Address - Zip Code:L8E5J5
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:257 JONES ROAD
Practice Address - Street 2:
Practice Address - City:STONEYCREEK
Practice Address - State:ON
Practice Address - Zip Code:L8E5J5
Practice Address - Country:CA
Practice Address - Phone:905-516-7036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-15
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13225122300000X
NY064970122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist