Provider Demographics
NPI:1689358376
Name:HARRAKA, SUHAIB (DMD)
Entity Type:Individual
Prefix:DR
First Name:SUHAIB
Middle Name:
Last Name:HARRAKA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1539 N FRANKLIN ST UNIT B
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19122-3613
Mailing Address - Country:US
Mailing Address - Phone:135-221-3083
Mailing Address - Fax:
Practice Address - Street 1:1 BELMONT AVE STE 516
Practice Address - Street 2:
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-1608
Practice Address - Country:US
Practice Address - Phone:484-278-4134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-13
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0441161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice