Provider Demographics
NPI:1114049541
Name:BHANJI, SHAMSI (DDS, MSD)
Entity Type:Individual
Prefix:DR
First Name:SHAMSI
Middle Name:
Last Name:BHANJI
Suffix:
Gender:F
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11011 MERIDIAN AVE N
Mailing Address - Street 2:SUITE 308
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-8967
Mailing Address - Country:US
Mailing Address - Phone:206-523-9618
Mailing Address - Fax:206-523-9518
Practice Address - Street 1:11011 MERIDIAN AVE N
Practice Address - Street 2:SUITE 308
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-8967
Practice Address - Country:US
Practice Address - Phone:206-523-9618
Practice Address - Fax:206-523-9518
Is Sole Proprietor?:No
Enumeration Date:2007-04-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA91221223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1598677OtherUNITED CONCORDIA
WA5046917Medicare ID - Type UnspecifiedDSHS