Provider Demographics
NPI:1922253467
Name:BENMERGUI, YUDAH ARI (DDS)
Entity Type:Individual
Prefix:DR
First Name:YUDAH
Middle Name:ARI
Last Name:BENMERGUI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 95TH ST
Mailing Address - Street 2:202
Mailing Address - City:SURFSIDE
Mailing Address - State:FL
Mailing Address - Zip Code:33154-2807
Mailing Address - Country:US
Mailing Address - Phone:305-865-0453
Mailing Address - Fax:
Practice Address - Street 1:260 95TH ST
Practice Address - Street 2:202
Practice Address - City:SURFSIDE
Practice Address - State:FL
Practice Address - Zip Code:33154-2807
Practice Address - Country:US
Practice Address - Phone:305-865-0453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-25
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN14993122300000X
FLDH2907124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No124Q00000XDental ProvidersDental Hygienist