Provider Demographics
NPI:1558754937
Name:GADE, SAMA ALKALAF (DMD)
Entity Type:Individual
Prefix:
First Name:SAMA
Middle Name:ALKALAF
Last Name:GADE
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 1:8191 BECKETT PARK DR
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-9303
Mailing Address - Country:US
Mailing Address - Phone:513-860-3660
Mailing Address - Fax:513-870-4932
Practice Address - Street 1:8191 BECKETT PARK DR
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-9303
Practice Address - Country:US
Practice Address - Phone:513-860-3660
Practice Address - Fax:513-870-4932
Is Sole Proprietor?:No
Enumeration Date:2015-03-10
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY30.025559122300000X
390200000X
OH30.025559122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program