Provider Demographics
NPI:1174407860
Name:SHARMA, GEETU (DDS, MPH, BDS)
Entity type:Individual
Prefix:DR
First Name:GEETU
Middle Name:
Last Name:SHARMA
Suffix:
Gender:F
Credentials:DDS, MPH, BDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18352 COMMERCIAL ST
Mailing Address - Street 2:
Mailing Address - City:LATHROP
Mailing Address - State:CA
Mailing Address - Zip Code:95330-8557
Mailing Address - Country:US
Mailing Address - Phone:669-238-9287
Mailing Address - Fax:
Practice Address - Street 1:5607 PACIFIC AVE
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-5161
Practice Address - Country:US
Practice Address - Phone:209-307-9306
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA112113122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist