Provider Demographics
NPI:1134258205
Name:KHAYAT, SAMER GEORGES (DMD)
Entity type:Individual
Prefix:DR
First Name:SAMER
Middle Name:GEORGES
Last Name:KHAYAT
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 1:210 WHITING STREET
Mailing Address - Street 2:SUITE 1
Mailing Address - City:HINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02043
Mailing Address - Country:US
Mailing Address - Phone:781-749-6050
Mailing Address - Fax:781-749-2201
Practice Address - Street 1:210 WHITING STREET
Practice Address - Street 2:SUITE 1
Practice Address - City:HINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02043
Practice Address - Country:US
Practice Address - Phone:781-749-6050
Practice Address - Fax:781-749-2201
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2015-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18558201223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics