Provider Demographics
NPI:1760645949
Name:HAMDI, AMAL (DDS)
Entity type:Individual
Prefix:DR
First Name:AMAL
Middle Name:
Last Name:HAMDI
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1045 PRIMERA BLVD
Mailing Address - Street 2:SUITE 1001
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746
Mailing Address - Country:US
Mailing Address - Phone:407-512-5700
Mailing Address - Fax:407-512-6579
Practice Address - Street 1:1045 PRIMERA BLVD
Practice Address - Street 2:SUITE 1001
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746
Practice Address - Country:US
Practice Address - Phone:407-512-5700
Practice Address - Fax:407-512-6579
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-08
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN18389122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No122300000XDental ProvidersDentist