Provider Demographics
NPI:1013466838
Name:SAINI, SHAMMI SAGAR (DMD)
Entity Type:Individual
Prefix:DR
First Name:SHAMMI
Middle Name:SAGAR
Last Name:SAINI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9163 FM 78
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CONVERSE
Mailing Address - State:TX
Mailing Address - Zip Code:78109-2147
Mailing Address - Country:US
Mailing Address - Phone:210-971-8989
Mailing Address - Fax:210-971-8988
Practice Address - Street 1:9163 FM 78
Practice Address - Street 2:SUITE 1
Practice Address - City:CONVERSE
Practice Address - State:TX
Practice Address - Zip Code:78109-2147
Practice Address - Country:US
Practice Address - Phone:210-971-8989
Practice Address - Fax:210-971-8988
Is Sole Proprietor?:No
Enumeration Date:2016-09-22
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32430122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist