Basic Information
| Provider Information | |||||||||
| NPI: | 1609955384 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ELMASRI | ||||||||
| FirstName: | MAHA | ||||||||
| MiddleName: | AZMI | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DDS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2 CAMBERLEY | ||||||||
| Address2: | |||||||||
| City: | LAGUNA NIGUEL | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926772942 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9493883809 | ||||||||
| FaxNumber: | 9493883809 | ||||||||
| Practice Location | |||||||||
| Address1: | 1808 W LINCOLN AVE | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | ANAHEIM | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928016742 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7147805665 | ||||||||
| FaxNumber: | 7144901585 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/03/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223G0001X | 47074 | CA | Y | Dental Providers | Dentist | General Practice |
No ID Information.