Provider Demographics
NPI:1316700578
Name:SANKARI, AMR
Entity type:Individual
Prefix:
First Name:AMR
Middle Name:
Last Name:SANKARI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 MOUNT VERNON ST APT 713
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02125-3150
Mailing Address - Country:US
Mailing Address - Phone:901-319-1506
Mailing Address - Fax:
Practice Address - Street 1:5002 AIRPORT RD NW # 30
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24012-1607
Practice Address - Country:US
Practice Address - Phone:540-900-4782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-31
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014191731223G0001X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program