Provider Demographics
NPI:1417748492
Name:CHARARA, SAMAR ALI
Entity type:Individual
Prefix:
First Name:SAMAR
Middle Name:ALI
Last Name:CHARARA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26601 ASHLEY ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-1906
Mailing Address - Country:US
Mailing Address - Phone:313-229-1241
Mailing Address - Fax:
Practice Address - Street 1:26601 ASHLEY ST
Practice Address - Street 2:
Practice Address - City:DEARBORN HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48127-1906
Practice Address - Country:US
Practice Address - Phone:313-229-1241
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-16
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901602581122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist