Provider Demographics
NPI:1205321239
Name:ALSAMIR FAMILY DENTISTRY, PLLC
Entity type:Organization
Organization Name:ALSAMIR FAMILY DENTISTRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ZAID
Authorized Official - Middle Name:
Authorized Official - Last Name:AL-SAMIR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:804-739-5791
Mailing Address - Street 1:13841 HULL STREET RD STE 1
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-2056
Mailing Address - Country:US
Mailing Address - Phone:804-739-5791
Mailing Address - Fax:
Practice Address - Street 1:13841 HULL STREET RD STE 1
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-2056
Practice Address - Country:US
Practice Address - Phone:804-739-5791
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-22
Last Update Date:2018-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014147711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty