Provider Demographics
NPI:1487108569
Name:BEKHIT, SAMEH
Entity type:Individual
Prefix:
First Name:SAMEH
Middle Name:
Last Name:BEKHIT
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 1:1300 N 45TH ST APT 1023
Mailing Address - Street 2:
Mailing Address - City:CORSICANA
Mailing Address - State:TX
Mailing Address - Zip Code:75110-1721
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:40 DORMODY CT STE A
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-2908
Practice Address - Country:US
Practice Address - Phone:831-373-3703
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-07
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31997122300000X
CA100307122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist