Provider Demographics
NPI:1326837873
Name:SHAMBAYATI, ALI (DDS)
Entity type:Individual
Prefix:DR
First Name:ALI
Middle Name:
Last Name:SHAMBAYATI
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4200 TIDWORTH DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-3126
Mailing Address - Country:US
Mailing Address - Phone:469-733-5422
Mailing Address - Fax:
Practice Address - Street 1:2800 8TH AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76110-3042
Practice Address - Country:US
Practice Address - Phone:817-904-9162
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-01
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program