Provider Demographics
NPI:1275795627
Name:AL-AISH, SANDY SAMI (DMD)
Entity Type:Individual
Prefix:DR
First Name:SANDY
Middle Name:SAMI
Last Name:AL-AISH
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 1:16519 MUNN RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44111-2013
Mailing Address - Country:US
Mailing Address - Phone:216-299-7728
Mailing Address - Fax:
Practice Address - Street 1:6315 PEARL RD
Practice Address - Street 2:
Practice Address - City:PARMA HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-3082
Practice Address - Country:US
Practice Address - Phone:440-842-2200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-26
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-022743122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist