Provider Demographics
NPI:1225400583
Name:SHERIF DESOUKY DDS
Entity Type:Organization
Organization Name:SHERIF DESOUKY DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHERIF
Authorized Official - Middle Name:
Authorized Official - Last Name:DESOUKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-420-1177
Mailing Address - Street 1:918 MAIN ST STE 1
Mailing Address - Street 2:
Mailing Address - City:FARMINGDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11735-5426
Mailing Address - Country:US
Mailing Address - Phone:516-420-1177
Mailing Address - Fax:516-454-7897
Practice Address - Street 1:918 MAIN ST STE 1
Practice Address - Street 2:
Practice Address - City:FARMINGDALE
Practice Address - State:NY
Practice Address - Zip Code:11735-5426
Practice Address - Country:US
Practice Address - Phone:516-420-1177
Practice Address - Fax:516-454-7897
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-27
Last Update Date:2015-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043061122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty