Provider Demographics
NPI:1609955384
Name:ELMASRI, MAHA AZMI (DDS)
Entity Type:Individual
Prefix:DR
First Name:MAHA
Middle Name:AZMI
Last Name:ELMASRI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2 CAMBERLEY
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-2942
Mailing Address - Country:US
Mailing Address - Phone:949-388-3809
Mailing Address - Fax:949-388-3809
Practice Address - Street 1:1808 W LINCOLN AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-6742
Practice Address - Country:US
Practice Address - Phone:714-780-5665
Practice Address - Fax:714-490-1585
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA470741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice