Provider Demographics
NPI:1962563791
Name:THALJI, SAMI K (DDS)
Entity type:Individual
Prefix:DR
First Name:SAMI
Middle Name:K
Last Name:THALJI
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 1:1801 MERLIN ST
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77414-3131
Mailing Address - Country:US
Mailing Address - Phone:979-323-8400
Mailing Address - Fax:979-323-8404
Practice Address - Street 1:1801 MERLIN ST
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:TX
Practice Address - Zip Code:77414-3131
Practice Address - Country:US
Practice Address - Phone:979-323-8400
Practice Address - Fax:979-323-8404
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX188131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice