Provider Demographics
NPI:1962789768
Name:SHAMLIAN, TAMARA N (DDS)
Entity type:Individual
Prefix:DR
First Name:TAMARA
Middle Name:N
Last Name:SHAMLIAN
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 1:7035 N. WEST AVE. SUITE 103
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711
Mailing Address - Country:US
Mailing Address - Phone:559-476-4537
Mailing Address - Fax:559-840-2606
Practice Address - Street 1:7035 N. WEST AVE. SUITE 103
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711
Practice Address - Country:US
Practice Address - Phone:559-476-4537
Practice Address - Fax:559-840-2606
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-08
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA607701223G0001X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No1223G0001XDental ProvidersDentistGeneral Practice