Provider Demographics
NPI:1699766329
Name:DIMARIANO, SHAINA M (DDS)
Entity type:Individual
Prefix:DR
First Name:SHAINA
Middle Name:M
Last Name:DIMARIANO
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 1:900 E BIDWELL ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-3345
Mailing Address - Country:US
Mailing Address - Phone:916-983-6655
Mailing Address - Fax:916-983-1079
Practice Address - Street 1:900 E BIDWELL ST
Practice Address - Street 2:SUITE 400
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-3345
Practice Address - Country:US
Practice Address - Phone:916-983-6655
Practice Address - Fax:916-983-1079
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA534461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice