Provider Demographics
NPI:1316197817
Name:KIM, SHARON MIA (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:SHARON
Middle Name:MIA
Last Name:KIM
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:150 E CENTENNIAL PKWY STE 113
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89084-1338
Mailing Address - Country:US
Mailing Address - Phone:702-642-1386
Mailing Address - Fax:
Practice Address - Street 1:150 E CENTENNIAL PKWY STE 113
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89084-1338
Practice Address - Country:US
Practice Address - Phone:702-642-1386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-22
Last Update Date:2025-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA577261223X0400X
NVS3-1761223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics