Provider Demographics
NPI:1407063662
Name:DHAMEJA, AMIT (MD, DDS)
Entity Type:Individual
Prefix:DR
First Name:AMIT
Middle Name:
Last Name:DHAMEJA
Suffix:
Gender:M
Credentials:MD, DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3225 TURTLE CREEK BLVD APT 516B
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-5460
Mailing Address - Country:US
Mailing Address - Phone:913-568-4974
Mailing Address - Fax:214-828-1714
Practice Address - Street 1:3307 UNICORN LAKE BLVD
Practice Address - Street 2:#191
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210
Practice Address - Country:US
Practice Address - Phone:913-568-4974
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2011-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS605491223S0112X
TX258911223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery