Provider Demographics
NPI:1497445316
Name:SELIMAN, BISHOY
Entity Type:Individual
Prefix:
First Name:BISHOY
Middle Name:
Last Name:SELIMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 HILLCREST DR
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-1228
Mailing Address - Country:US
Mailing Address - Phone:575-392-5437
Mailing Address - Fax:
Practice Address - Street 1:3920 N LOVINGTON HWY STE 400
Practice Address - Street 2:
Practice Address - City:HOBBS
Practice Address - State:NM
Practice Address - Zip Code:88240-1177
Practice Address - Country:US
Practice Address - Phone:575-392-5437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-12
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDB-2024-00201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice