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General NPI Number Information
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NPI Number | 1669045969
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Entity Type | Individual
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Provider Name | HENNAH SHAMJI
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Gender | Female
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Dates
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Enumeration Date | 07/23/2021
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Last Update Date | 05/14/2025
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Provider Practice Location Address
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Address Line | 112 GULF ST
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City | CIBOLO
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State | TX
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Zip | 78108-3845
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Country | US
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Telephone | 210-724-4100
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Fax |
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Provider Business Mailing Address
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Address Line | 2419 GREYSTONE LNDG
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City | SAN ANTONIO
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State | TX
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Zip | 78259-1865
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Country | US
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Telephone | 281-704-4930
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 38110
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 38110
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License Number State | TX
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