Provider Demographics
NPI:1952515991
Name:AKKARI, FADI N (DDS)
Entity Type:Individual
Prefix:
First Name:FADI
Middle Name:N
Last Name:AKKARI
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 1:8635 BARNWOOD LN
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92508-7127
Mailing Address - Country:US
Mailing Address - Phone:951-786-0600
Mailing Address - Fax:
Practice Address - Street 1:3679 ARLINGTON AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-3940
Practice Address - Country:US
Practice Address - Phone:951-786-0600
Practice Address - Fax:951-786-0700
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice