Provider Demographics
NPI:1417218389
Name:BASSIL AKEL DMD PLLC
Entity Type:Organization
Organization Name:BASSIL AKEL DMD PLLC
Other - Org Name:FAMILY DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BASSIL
Authorized Official - Middle Name:
Authorized Official - Last Name:AKEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-581-9228
Mailing Address - Street 1:1600 N STATE ROAD 7
Mailing Address - Street 2:SUITE 400
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33313-5853
Mailing Address - Country:US
Mailing Address - Phone:954-581-9228
Mailing Address - Fax:954-626-3650
Practice Address - Street 1:1600 N STATE ROAD 7
Practice Address - Street 2:SUITE 400
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33313-5853
Practice Address - Country:US
Practice Address - Phone:954-581-9228
Practice Address - Fax:954-626-3650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-06
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000338400Medicaid