Healthcare Provider Details

I. General information

NPI: 1164322905
Provider Name (Legal Business Name): TAMARA N SHAMLIAN DDS, MS, A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2026
Last Update Date: 11/05/2026
Certification Date: 11/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7035 N WEST AVE STE 103
FRESNO CA
93711-7182
US

IV. Provider business mailing address

7035 N WEST AVE STE 103
FRESNO CA
93711-7182
US

V. Phone/Fax

Practice location:
  • Phone: 559-476-4537
  • Fax: 559-840-2606
Mailing address:
  • Phone: 559-476-4537
  • Fax: 559-840-2606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. TAMARA N SHAMLIAN
Title or Position: PRESIDENT
Credential: DDS
Phone: 559-500-9990