Provider Demographics
NPI:1346455276
Name:AKKARA, DAVID J (DMD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:J
Last Name:AKKARA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 N FORMOSA AVE
Mailing Address - Street 2:SUITE ONE
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-3009
Mailing Address - Country:US
Mailing Address - Phone:407-898-2371
Mailing Address - Fax:
Practice Address - Street 1:3600 N FORMOSA AVE
Practice Address - Street 2:SUITE ONE
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-3009
Practice Address - Country:US
Practice Address - Phone:407-898-2371
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2010-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN17897122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist