MEDICARE: DR. BUSHRA DINKHA DMD

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	DN25940	FL

General Provider Information

NPI Number	:	1861063315
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BUSHRA DINKHA DMD

Provider Business Mailing Address
First Line	:	2770 NE 58TH ST
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-2728
Country	:	US
Telephone Number	:	773-727-8121
Fax Number	:

Provider Business Practice Location Address
First Line	:	2770 NE 58TH ST
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-2728
Country	:	US
Telephone Number	:	773-727-8121
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/06/2021
Last Update Date	:	07/06/2021

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