Provider Demographics
NPI:1013269885
Name:RIVERSIDE SMILES DENTISTRY DR AKKARI DDS
Entity Type:Organization
Organization Name:RIVERSIDE SMILES DENTISTRY DR AKKARI DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:FADI
Authorized Official - Middle Name:
Authorized Official - Last Name:AKKARI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:951-680-0505
Mailing Address - Street 1:6912 BROCKTON AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-3802
Mailing Address - Country:US
Mailing Address - Phone:951-680-0505
Mailing Address - Fax:
Practice Address - Street 1:6912 BROCKTON AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-3802
Practice Address - Country:US
Practice Address - Phone:951-680-0505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-04
Last Update Date:2012-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty