Provider Demographics
NPI:1457435182
Name:SEDKI, BASHAR ESSAM (DDS)
Entity Type:Individual
Prefix:DR
First Name:BASHAR
Middle Name:ESSAM
Last Name:SEDKI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39470 SPRINGWATER DR
Mailing Address - Street 2:
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48168-3959
Mailing Address - Country:US
Mailing Address - Phone:248-231-9063
Mailing Address - Fax:
Practice Address - Street 1:2900 UNION LAKE RD
Practice Address - Street 2:
Practice Address - City:COMMERCE TWP
Practice Address - State:MI
Practice Address - Zip Code:48382-3500
Practice Address - Country:US
Practice Address - Phone:248-360-9620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI181761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice