Provider Demographics
NPI:1093157018
Name:DESOKY, ABDELAZEEM HAZEM (DDS)
Entity Type:Individual
Prefix:DR
First Name:ABDELAZEEM
Middle Name:HAZEM
Last Name:DESOKY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27060 CEDAR RD
Mailing Address - Street 2:806
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-8103
Mailing Address - Country:US
Mailing Address - Phone:216-672-8064
Mailing Address - Fax:
Practice Address - Street 1:27060 CEDAR RD
Practice Address - Street 2:806
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-8103
Practice Address - Country:US
Practice Address - Phone:216-672-8064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-18
Last Update Date:2013-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRES.31471223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics