Provider Demographics
NPI:1215360649
Name:EL-MAASRI, JOANNA (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOANNA
Middle Name:
Last Name:EL-MAASRI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:JOANNA
Other - Middle Name:EL-MAASRI
Other - Last Name:REPPAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1 CIVIC CENTER DR
Mailing Address - Street 2:SUITE 230
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92069-2918
Mailing Address - Country:US
Mailing Address - Phone:760-798-4178
Mailing Address - Fax:
Practice Address - Street 1:1 CIVIC CENTER DR
Practice Address - Street 2:SUITE 230
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92069-2918
Practice Address - Country:US
Practice Address - Phone:760-798-4178
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-21
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA627401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice