Provider Demographics
NPI:1265443378
Name:GOLANI, SHAMIRAN Y (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHAMIRAN
Middle Name:Y
Last Name:GOLANI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 510244
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48151-6244
Mailing Address - Country:US
Mailing Address - Phone:248-548-1178
Mailing Address - Fax:
Practice Address - Street 1:22720 WOODWARD AVE
Practice Address - Street 2:107
Practice Address - City:FERNDALE
Practice Address - State:MI
Practice Address - Zip Code:48220-2920
Practice Address - Country:US
Practice Address - Phone:248-548-1178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010146011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice