Provider Demographics
NPI:1437371713
Name:SAMI M. GHAREEB, DDS
Entity type:Organization
Organization Name:SAMI M. GHAREEB, DDS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICKY
Authorized Official - Middle Name:
Authorized Official - Last Name:BOGGESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-757-7441
Mailing Address - Street 1:PO BOX 566
Mailing Address - Street 2:
Mailing Address - City:POCA
Mailing Address - State:WV
Mailing Address - Zip Code:25159-0566
Mailing Address - Country:US
Mailing Address - Phone:304-755-3931
Mailing Address - Fax:
Practice Address - Street 1:178 MAIN ST.
Practice Address - Street 2:
Practice Address - City:POCA
Practice Address - State:WV
Practice Address - Zip Code:25159
Practice Address - Country:US
Practice Address - Phone:304-755-3931
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV21181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV1780791061OtherINDIVIDUAL NPI #
WV1780791061OtherINDIVIDUAL NPI #
WV1780791061OtherINDIVIDUAL NPI #