Provider Demographics
NPI:1063130615
Name:DAVAMI, DONNA (DDS)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:DAVAMI
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 1:948 TUSCAN LN
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95864-6177
Mailing Address - Country:US
Mailing Address - Phone:916-290-3547
Mailing Address - Fax:
Practice Address - Street 1:8211 BRUCEVILLE RD STE 155
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-2313
Practice Address - Country:US
Practice Address - Phone:916-525-7635
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-19
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS1077131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice