Provider Demographics
NPI:1023636446
Name:SAMONA, JOSEPH (DDS)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:SAMONA
Suffix:
Gender:M
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:UT HEALTH SCIENCE CENTER AT SAN ANTONIO
Mailing Address - Street 2:8210 FLOYD CURL DRIVE, MSC 8103
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-3923
Mailing Address - Country:US
Mailing Address - Phone:210-450-3273
Mailing Address - Fax:210-450-2223
Practice Address - Street 1:39242 DEQUINDRE RD STE 106
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310-1767
Practice Address - Country:US
Practice Address - Phone:586-795-5678
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-13
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXETN763390200000X
MI2901600830122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program