Provider Demographics
NPI:1326202029
Name:BESSER, SAMANTHA ROBYN HAAS (DMD)
Entity Type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:ROBYN HAAS
Last Name:BESSER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:ROBYN
Other - Last Name:HAAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:6222 WILSHIRE BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-5100
Mailing Address - Country:US
Mailing Address - Phone:323-933-4444
Mailing Address - Fax:
Practice Address - Street 1:1102 12TH ST APT 2
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403-5446
Practice Address - Country:US
Practice Address - Phone:310-780-4825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-11
Last Update Date:2013-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA535211223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics