Provider Demographics
NPI:1558837856
Name:BMSK, PLLC
Entity type:Organization
Organization Name:BMSK, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMEH
Authorized Official - Middle Name:
Authorized Official - Last Name:KASSEM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-729-7447
Mailing Address - Street 1:19490 SANDRIDGE WAY STE 110
Mailing Address - Street 2:
Mailing Address - City:LANSDOWNE
Mailing Address - State:VA
Mailing Address - Zip Code:20176-3470
Mailing Address - Country:US
Mailing Address - Phone:703-729-7447
Mailing Address - Fax:703-858-0448
Practice Address - Street 1:823 S KING ST STE E
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20175-3920
Practice Address - Country:US
Practice Address - Phone:703-777-3150
Practice Address - Fax:703-777-2464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-15
Last Update Date:2018-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty