Provider Demographics
NPI:1497266092
Name:ELSAYED, KEROLOS RAGAEY HELMY (BDS,DMD,MSD)
Entity Type:Individual
Prefix:DR
First Name:KEROLOS
Middle Name:RAGAEY HELMY
Last Name:ELSAYED
Suffix:
Gender:M
Credentials:BDS,DMD,MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 HATTERAS AVE UNIT 2
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-7400
Mailing Address - Country:US
Mailing Address - Phone:352-394-0150
Mailing Address - Fax:
Practice Address - Street 1:265 HATTERAS AVE UNIT 2
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-7400
Practice Address - Country:US
Practice Address - Phone:352-394-0150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-23
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN278391223E0200X
FL278391223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty