Provider Demographics
NPI:1255426821
Name:GABRIEL, SHARON (DDS)
Entity type:Individual
Prefix:DR
First Name:SHARON
Middle Name:
Last Name:GABRIEL
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 1:320 N VERDUGO RD
Mailing Address - Street 2:STE 100
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91206-5238
Mailing Address - Country:US
Mailing Address - Phone:818-548-0608
Mailing Address - Fax:818-548-0648
Practice Address - Street 1:320 N VERDUGO RD
Practice Address - Street 2:STE 100
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91206-5238
Practice Address - Country:US
Practice Address - Phone:818-548-0608
Practice Address - Fax:818-548-0648
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2012-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA433381223G0001X
HIDT-1929122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist