Provider Demographics
NPI:1548799182
Name:SAMER R. NAMOO DDS, INC
Entity type:Organization
Organization Name:SAMER R. NAMOO DDS, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMER
Authorized Official - Middle Name:RAAD
Authorized Official - Last Name:NAMOO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:619-464-3191
Mailing Address - Street 1:8419 LA MESA BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-5381
Mailing Address - Country:US
Mailing Address - Phone:619-464-3191
Mailing Address - Fax:619-464-0534
Practice Address - Street 1:8419 LA MESA BLVD STE A
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-5381
Practice Address - Country:US
Practice Address - Phone:619-464-3191
Practice Address - Fax:619-464-0534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA64546261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental