Active NPI
Robert E. Sharp, D.D.S.
- Periodontics
- Queensbury, NY
National Provider Identifier
1457393498
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- NY 32824
- Practice address
- 16 Hunter Brook LN
Queensbury, NY 12804-5858 - Phone
- (518) 793-5995
- Fax
- (518) 793-5908
- NPI assigned
- Jun 12, 2006
- Last updated
- Nov 15, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | NY 32824 | NY | Primary |
Addresses
Primary practice location
16 Hunter Brook LN
Queensbury, NY 12804-5858
Mailing address
16 Hunter Brook LN
Queensbury, NY 12804-5858
Phone (518) 793-5995
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20141208001942 | NY | Order and Referring Only - Oral Surgery | 0648592329 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NY 32824 | NY | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1289779200000",
"number": "1457393498",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16 HUNTER BROOK LN",
"city": "QUEENSBURY",
"state": "NY",
"postal_code": "128045858",
"telephone_number": "518-793-5995",
"fax_number": "518-793-5908"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16 HUNTER BROOK LN",
"city": "QUEENSBURY",
"state": "NY",
"postal_code": "128045858",
"telephone_number": "518-793-5995",
"fax_number": "518-793-5908"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHARP",
"first_name": "ROBERT",
"middle_name": "E.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-12",
"last_updated": "2010-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "NY",
"license": "NY 32824",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Queensbury, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.