Provider Demographics
NPI:1558381301
Name:AMANI ALKHAIRI DMD PA
Entity Type:Organization
Organization Name:AMANI ALKHAIRI DMD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AMANI
Authorized Official - Middle Name:ALMAMOUN
Authorized Official - Last Name:ALKHAIRI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:407-282-0134
Mailing Address - Street 1:1009 AMBER RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32807-3427
Mailing Address - Country:US
Mailing Address - Phone:407-282-0134
Mailing Address - Fax:407-282-8251
Practice Address - Street 1:1009 AMBER RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32807-3427
Practice Address - Country:US
Practice Address - Phone:407-282-0134
Practice Address - Fax:407-282-8251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2012-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN161221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty