Provider Demographics
NPI:1619125002
Name:OUATIK, NABIL (DMD, MSC)
Entity Type:Individual
Prefix:DR
First Name:NABIL
Middle Name:
Last Name:OUATIK
Suffix:
Gender:M
Credentials:DMD, MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 W SERVICE RD
Mailing Address - Street 2:A238
Mailing Address - City:CHAMPLAIN
Mailing Address - State:NY
Mailing Address - Zip Code:12919-4440
Mailing Address - Country:US
Mailing Address - Phone:514-293-1270
Mailing Address - Fax:
Practice Address - Street 1:93-20A ROOSEVELT AVE
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-7904
Practice Address - Country:US
Practice Address - Phone:518-825-0025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-28
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-0228421223P0221X
NY0564411223P0221X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry