Healthcare Provider Details

I. General information

NPI: 1568563757
Provider Name (Legal Business Name): SAADIA BUKHARI D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 HUBER VILLAGE BLVD
WESTERVILLE OH
43081-3305
US

IV. Provider business mailing address

6429 GRASSLANDS CT
WESTERVILLE OH
43082-9594
US

V. Phone/Fax

Practice location:
  • Phone: 614-882-8000
  • Fax: 614-882-9684
Mailing address:
  • Phone: 614-423-4113
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number30021299
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: