MEDICARE: SAMI HERSEL DDS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1083582456
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAMI HERSEL DDS INC

Provider Business Mailing Address
First Line	:	1600 W BURBANK BLVD
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91506-1311
Country	:	US
Telephone Number	:	818-558-5630
Fax Number	:

Provider Business Practice Location Address
First Line	:	1600 W BURBANK BLVD
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91506-1311
Country	:	US
Telephone Number	:	818-558-5630
Fax Number	:

Authorized Official
Title or Position	:	DR
Name	:	SAMI HERSEL
Credential	:	DDS
Telephone Number	:	818-558-5630

Provider Enumeration Date	:	10/28/2025
Last Update Date	:	10/28/2025

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