Provider Demographics
NPI:1376234351
Name:DARWISH, OMAR (DDS)
Entity Type:Individual
Prefix:DR
First Name:OMAR
Middle Name:
Last Name:DARWISH
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 1:553 66TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-4920
Mailing Address - Country:US
Mailing Address - Phone:646-469-2285
Mailing Address - Fax:
Practice Address - Street 1:553 66TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-4920
Practice Address - Country:US
Practice Address - Phone:646-469-2285
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-18
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program