Provider Demographics
NPI:1649606948
Name:SHEEHY, OMARI KAMAL (DDS)
Entity type:Individual
Prefix:DR
First Name:OMARI
Middle Name:KAMAL
Last Name:SHEEHY
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 1:810 W DR MARTIN LUTHER KING JR BLVD
Mailing Address - Street 2:SK 2900
Mailing Address - City:SEFFNER
Mailing Address - State:FL
Mailing Address - Zip Code:33584
Mailing Address - Country:US
Mailing Address - Phone:813-330-2006
Mailing Address - Fax:
Practice Address - Street 1:810 W DR MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:SK 2900
Practice Address - City:SEFFNER
Practice Address - State:FL
Practice Address - Zip Code:33584
Practice Address - Country:US
Practice Address - Phone:813-330-2006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-18
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 20388122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist