Provider Demographics
NPI:1659618148
Name:SHAMLIAN DENTISTRY INC.
Entity Type:Organization
Organization Name:SHAMLIAN DENTISTRY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:SHAMLINA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MAGD
Authorized Official - Phone:559-438-4642
Mailing Address - Street 1:7077 N WEST AVE STE 107
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-0669
Mailing Address - Country:US
Mailing Address - Phone:559-438-4646
Mailing Address - Fax:559-438-4652
Practice Address - Street 1:7077 N WEST AVE STE 107
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-0669
Practice Address - Country:US
Practice Address - Phone:559-438-4646
Practice Address - Fax:559-438-4652
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-03
Last Update Date:2013-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA288121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty