Provider Demographics
NPI:1225609886
Name:SAMI, REBECA (DDS)
Entity Type:Individual
Prefix:
First Name:REBECA
Middle Name:
Last Name:SAMI
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 1:5189 DUKE CT
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21703-2854
Mailing Address - Country:US
Mailing Address - Phone:571-991-5725
Mailing Address - Fax:
Practice Address - Street 1:3370 URBANA PIKE
Practice Address - Street 2:
Practice Address - City:IJAMSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21754-9435
Practice Address - Country:US
Practice Address - Phone:301-605-1157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-06
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD17359122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist