Provider Demographics
NPI:1700040557
Name:AKEL, BASSIL (DMD)
Entity Type:Individual
Prefix:DR
First Name:BASSIL
Middle Name:
Last Name:AKEL
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 1:1600 N STATE ROAD 7
Mailing Address - Street 2:SUITE 400
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33313-5853
Mailing Address - Country:US
Mailing Address - Phone:954-581-9228
Mailing Address - Fax:954-626-3650
Practice Address - Street 1:1600 N STATE ROAD 7
Practice Address - Street 2:SUITE 400
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33313-5853
Practice Address - Country:US
Practice Address - Phone:954-581-9228
Practice Address - Fax:954-626-3650
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-10
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN183051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL075695400Medicaid