Provider Demographics
NPI:1528617289
Name:DALWAI, SAFA SHAMIM (DMD)
Entity type:Individual
Prefix:MS
First Name:SAFA
Middle Name:SHAMIM
Last Name:DALWAI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21000 GOSLING RD
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77388-5230
Mailing Address - Country:US
Mailing Address - Phone:678-654-8655
Mailing Address - Fax:
Practice Address - Street 1:8707 SPRING CYPRESS RD
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-3330
Practice Address - Country:US
Practice Address - Phone:281-320-1150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-05
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37011122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1528617289OtherNPI