Provider Demographics
NPI:1881766723
Name:BAHRI, SAMI A
Entity type:Individual
Prefix:DR
First Name:SAMI
Middle Name:A
Last Name:BAHRI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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:904-448-9560
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:904-448-9560
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2009-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL121221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice