Healthcare Provider Details

I. General information

NPI: 1598162083
Provider Name (Legal Business Name): BASMAH HAM ALAMINI BDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/26/2014
Last Update Date: 11/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2124 CORNELL RD
CLEVELAND OH
44106
US

IV. Provider business mailing address

2124 CORNELL RD
CLEVELAND OH
44106
US

V. Phone/Fax

Practice location:
  • Phone: 216-368-6757
  • Fax: 216-368-3204
Mailing address:
  • Phone: 216-368-6757
  • Fax: 216-368-3204

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number3416
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: