Provider Demographics
NPI:1922625813
Name:AKKARI, AMANDA STEPHANIE (DDS)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:STEPHANIE
Last Name:AKKARI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8656 W HIGHWAY 71 BLDG D
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78735-8196
Mailing Address - Country:US
Mailing Address - Phone:512-382-1969
Mailing Address - Fax:
Practice Address - Street 1:8656 W HIGHWAY 71 BLDG D
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78735-8196
Practice Address - Country:US
Practice Address - Phone:512-382-1969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-26
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK73111223G0001X
TX374431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice