Bashar Al Khouri
Individual provider Active NPI Dentist · Brandon, FL
NPI 1801948435 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1801948435
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 13257 (FL)
- Practice address
- 121 W Windhorst Rd
Brandon, FL 33510-2434 - Phone
- (813) 681-8151
- Fax
- (813) 643-7977
- NPI assigned
- Jan 16, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13257 | FL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bashar Al Khouri,PA | Current |
Accepting new patients |
Locations
121 W Windhorst Rd
Brandon, FL 33510
Phone (813) 681-8151
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 13257 | FL | Yes |
Addresses
Primary practice location
121 W Windhorst Rd
Brandon, FL 33510-2434
Mailing address
121 W Windhorst Rd
Brandon, FL 33510-2434
Phone (813) 681-8151
Other providers in Brandon, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.