Provider Demographics
NPI:1598932758
Name:B SEDKI DDS PLLC
Entity Type:Organization
Organization Name:B SEDKI DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BASHAR
Authorized Official - Middle Name:ESSAM
Authorized Official - Last Name:SEDKI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:248-360-9620
Mailing Address - Street 1:2900 UNION LAKE RD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:COMMERCE TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48382
Mailing Address - Country:US
Mailing Address - Phone:248-360-9620
Mailing Address - Fax:248-360-5337
Practice Address - Street 1:2900 UNION LAKE RD
Practice Address - Street 2:SUITE 220
Practice Address - City:COMMERCE TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48382
Practice Address - Country:US
Practice Address - Phone:248-360-9620
Practice Address - Fax:248-360-5337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-15
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010181761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty