Healthcare Provider Details

I. General information

NPI: 1740108679
Provider Name (Legal Business Name): BASHAR AHMAD SADAT DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

572 RITCHIE HWY STE F
SEVERNA PARK MD
21146-2966
US

IV. Provider business mailing address

2494 RIVA RD APT 1303
ANNAPOLIS MD
21401-7697
US

V. Phone/Fax

Practice location:
  • Phone: 410-647-4094
  • Fax:
Mailing address:
  • Phone: 304-888-3202
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number18860
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: