Provider Demographics
NPI:1174703664
Name:DR. SHARON LONG-STOKES, D.D.S., P.A.
Entity type:Organization
Organization Name:DR. SHARON LONG-STOKES, D.D.S., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:ANITA
Authorized Official - Last Name:LONG-STOKES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:336-275-9922
Mailing Address - Street 1:106 S MURROW BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-2944
Mailing Address - Country:US
Mailing Address - Phone:336-275-9922
Mailing Address - Fax:336-275-0040
Practice Address - Street 1:106 S MURROW BLVD STE 100
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-2944
Practice Address - Country:US
Practice Address - Phone:336-275-9922
Practice Address - Fax:336-275-0040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-13
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6452122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0217YOtherBCBS
NC8995377Medicaid
NC809129OtherUNITED CONCORDIA