Healthcare Provider Details

I. General information

NPI: 1932726049
Provider Name (Legal Business Name): USAMA A AL SAEDI DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2020
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 LEE ST
LEESBURG FL
34748-4913
US

IV. Provider business mailing address

106 LEE ST
LEESBURG FL
34748-4913
US

V. Phone/Fax

Practice location:
  • Phone: 352-763-9157
  • Fax:
Mailing address:
  • Phone: 352-763-9157
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN32311
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: