Provider Demographics
NPI:1285335299
Name:AL-KINANI, SAMARH (DDS)
Entity type:Individual
Prefix:
First Name:SAMARH
Middle Name:
Last Name:AL-KINANI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4997 N TWIN CITY HWY STE 140
Mailing Address - Street 2:
Mailing Address - City:PORT ARTHUR
Mailing Address - State:TX
Mailing Address - Zip Code:77642-5851
Mailing Address - Country:US
Mailing Address - Phone:424-434-9254
Mailing Address - Fax:
Practice Address - Street 1:4997 N TWIN CITY HWY STE 140
Practice Address - Street 2:
Practice Address - City:PORT ARTHUR
Practice Address - State:TX
Practice Address - Zip Code:77642-5851
Practice Address - Country:US
Practice Address - Phone:409-548-0685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-15
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX395421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice