Provider Demographics
NPI:1356793848
Name:KAPIL, SAMEER (DMD)
Entity type:Individual
Prefix:
First Name:SAMEER
Middle Name:
Last Name:KAPIL
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 1:20905 EASTSIDE DR # D1
Mailing Address - Street 2:P.O BOX 671989
Mailing Address - City:CHUGIAK
Mailing Address - State:AK
Mailing Address - Zip Code:99567-6286
Mailing Address - Country:US
Mailing Address - Phone:907-688-1488
Mailing Address - Fax:
Practice Address - Street 1:20905 EASTSIDE DR
Practice Address - Street 2:D1
Practice Address - City:CHUGIAK
Practice Address - State:AK
Practice Address - Zip Code:99567-6286
Practice Address - Country:US
Practice Address - Phone:907-688-1488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-07
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK112520122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist