Provider Demographics
NPI:1174775803
Name:SHARMA, TRIPTY (DDS)
Entity type:Individual
Prefix:DR
First Name:TRIPTY
Middle Name:
Last Name:SHARMA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2770 HIGHLAND AVENUE
Mailing Address - Street 2:UNIT 103
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148
Mailing Address - Country:US
Mailing Address - Phone:630-426-6996
Mailing Address - Fax:630-376-6382
Practice Address - Street 1:2770 HIGHLAND AVENUE
Practice Address - Street 2:UNIT 103
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148
Practice Address - Country:US
Practice Address - Phone:630-426-6996
Practice Address - Fax:630-376-6382
Is Sole Proprietor?:No
Enumeration Date:2008-10-13
Last Update Date:2015-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL3190188161223G0001X
IL019029655122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice