Provider Demographics
NPI:1568684298
Name:AKRAM SAMUEL, DDS, INC
Entity Type:Organization
Organization Name:AKRAM SAMUEL, DDS, INC
Other - Org Name:SMART DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AKRAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMUEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-847-5100
Mailing Address - Street 1:16152 BEACH BLVD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-3806
Mailing Address - Country:US
Mailing Address - Phone:714-847-5100
Mailing Address - Fax:714-847-5005
Practice Address - Street 1:16152 BEACH BLVD
Practice Address - Street 2:SUITE 140
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-3806
Practice Address - Country:US
Practice Address - Phone:714-847-5100
Practice Address - Fax:714-847-5005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA534811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty