Individual provider Active NPI

Sanjeev K Sharma, DMD

  • Dentist
  • Baltimore, MD
National Provider Identifier
1629436902
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
16575 Issued in MD
Practice address
1401 Merritt Blvd
Baltimore, MD 21222-2140
Phone
(609) 216-1865
Fax
(609) 216-1865
NPI assigned
Feb 2, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dentist 122300000X 16575 MD Primary

Addresses

Primary practice location

1401 Merritt Blvd
Baltimore, MD 21222-2140

Mailing address

1401 Merritt Blvd
Baltimore, MD 21222-2140
Phone (609) 216-1865

Other practice location 1

2920 N 4th St
Dental Suite
Flagstaff, AZ 86004-1816
Phone (609) 216-1865

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
16575MDMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1454371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1629436902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 MERRITT BLVD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212222140",
            "telephone_number": "609-216-1865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 MERRITT BLVD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212222140",
            "telephone_number": "609-216-1865",
            "fax_number": "609-216-1865"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2920 N 4th St",
            "address_2": "Dental Suite",
            "address_purpose": "LOCATION",
            "city": "Flagstaff",
            "state": "AZ",
            "postal_code": "860041816",
            "country_code": "US",
            "telephone_number": "609-216-1865",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHARMA",
        "first_name": "SANJEEV",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-02-02",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "16575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.