Provider Demographics
NPI:1912662149
Name:OMAR ALMAKKY, DMD, LLC
Entity Type:Organization
Organization Name:OMAR ALMAKKY, DMD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:OMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:ALMAKKY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:937-823-0205
Mailing Address - Street 1:5708 CHANCERY PL
Mailing Address - Street 2:
Mailing Address - City:LIBERTY TWP
Mailing Address - State:OH
Mailing Address - Zip Code:45011-8766
Mailing Address - Country:US
Mailing Address - Phone:937-823-0205
Mailing Address - Fax:
Practice Address - Street 1:11319 SPRINGFIELD PIKE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45246-4201
Practice Address - Country:US
Practice Address - Phone:937-823-0205
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-02
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental