Provider Demographics
NPI:1518163948
Name:ELBAYOUMY, SHARIF L (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:SHARIF
Middle Name:L
Last Name:ELBAYOUMY
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1252 IRVINE BLVD
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-3531
Mailing Address - Country:US
Mailing Address - Phone:714-832-9151
Mailing Address - Fax:
Practice Address - Street 1:1252 IRVINE BLVD
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-3531
Practice Address - Country:US
Practice Address - Phone:714-865-3725
Practice Address - Fax:714-832-9151
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50907122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist