Individual provider Active NPI

Mary Lauren Sharp, DMD

  • Public Health Dentistry
  • Clinton, TN
National Provider Identifier
1427586619
Registry record updated Oct 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health DentistryTaxonomy code 1223D0001X
License
11050 Issued in TN
Practice address
710 N Main St
Clinton, TN 37716-3143
Phone
(865) 425-8803
NPI assigned
Jun 1, 2017
Last updated
Oct 1, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health Dentistry 1223D0001X 11050 TN Primary
Student in an Organized Health Care Education/Training Program 390200000X AL

Addresses

Primary practice location

710 N Main St
Clinton, TN 37716-3143

Mailing address

2419 Surrey LN SE
Decatur, AL 35601-6903
Phone (256) 318-3800

Other practice location 1

1930 Alcoa Highway
Medical Building A, Suite 340
Knoxville, TN 37920-6999
Phone (865) 305-9440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181017003264 TN Order and Referring Only - DentistPractitioner - Dentist 5597017632

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Orthodontics LLC Current Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1496275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569888000000",
    "number": "1427586619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2419 SURREY LN SE",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356016903",
            "telephone_number": "256-318-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 N MAIN ST",
            "city": "CLINTON",
            "state": "TN",
            "postal_code": "377163143",
            "telephone_number": "865-425-8803"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1930 Alcoa Highway",
            "address_2": "Medical Building A, Suite 340",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379206999",
            "country_code": "US",
            "telephone_number": "865-305-9440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHARP",
        "first_name": "MARY",
        "middle_name": "LAUREN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-01",
        "last_updated": "2019-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "TN",
            "license": "11050",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "AL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, TN

Sources for this page

Verify at the official NPI Registry.