Provider Demographics
NPI:1336821560
Name:THAI, DAYNA (DDS)
Entity Type:Individual
Prefix:
First Name:DAYNA
Middle Name:
Last Name:THAI
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 1:2808 E MUNCIE AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-4954
Mailing Address - Country:US
Mailing Address - Phone:559-579-9999
Mailing Address - Fax:
Practice Address - Street 1:4129 S MOONEY BLVD STE B
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-9147
Practice Address - Country:US
Practice Address - Phone:559-732-1953
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA109071122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist