Provider Demographics
NPI:1669743092
Name:ALKHAIRI, AMANI ALMAMOUN (DMD)
Entity type:Individual
Prefix:DR
First Name:AMANI
Middle Name:ALMAMOUN
Last Name:ALKHAIRI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1009 AMBER RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32807-3427
Mailing Address - Country:US
Mailing Address - Phone:407-282-0134
Mailing Address - Fax:407-282-8251
Practice Address - Street 1:1009 AMBER RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32807-3427
Practice Address - Country:US
Practice Address - Phone:407-282-0134
Practice Address - Fax:407-282-8251
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-17
Last Update Date:2012-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN161221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice