Provider Demographics
NPI:1932322864
Name:SAMAIN, OMAIMA SAMI (DDS)
Entity Type:Individual
Prefix:DR
First Name:OMAIMA
Middle Name:SAMI
Last Name:SAMAIN
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 1:18395 N 114TH AVE
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-6967
Mailing Address - Country:US
Mailing Address - Phone:623-875-0043
Mailing Address - Fax:
Practice Address - Street 1:407 N 4TH ST
Practice Address - Street 2:
Practice Address - City:BUCKEYE
Practice Address - State:AZ
Practice Address - Zip Code:85326-2442
Practice Address - Country:US
Practice Address - Phone:623-327-3206
Practice Address - Fax:623-327-0563
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD65441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZD6544OtherDENTAL LICENSE