Provider Demographics
NPI:1609191832
Name:RIZK, SAFWAT S (DDS)
Entity Type:Individual
Prefix:DR
First Name:SAFWAT
Middle Name:S
Last Name:RIZK
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 1:405 92ND STREET
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209
Mailing Address - Country:US
Mailing Address - Phone:718-745-8500
Mailing Address - Fax:718-745-8844
Practice Address - Street 1:405 92ND STREET
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209
Practice Address - Country:US
Practice Address - Phone:718-745-8500
Practice Address - Fax:718-745-8844
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-31
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY50P71155122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist