Provider Demographics
NPI:1841493186
Name:BAHRI DENTAL GROUP
Entity type:Organization
Organization Name:BAHRI DENTAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMI
Authorized Official - Middle Name:
Authorized Official - Last Name:BAHRI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-448-9669
Mailing Address - Street 1:8131 BAYMEADOWS CIR W
Mailing Address - Street 2:SUITE 102
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-2012
Mailing Address - Country:US
Mailing Address - Phone:904-448-9669
Mailing Address - Fax:
Practice Address - Street 1:8131 BAYMEADOWS CIR W
Practice Address - Street 2:SUITE 102
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-2012
Practice Address - Country:US
Practice Address - Phone:904-448-9669
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-06
Last Update Date:2009-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12122122300000X
FL16187122300000X
FL16828122300000X
FL12589122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty