Provider Demographics
NPI:1659542496
Name:MAGDY ELSHAROUNY DDS PC
Entity Type:Organization
Organization Name:MAGDY ELSHAROUNY DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MAGDY
Authorized Official - Middle Name:
Authorized Official - Last Name:ELSHAROUNY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-886-5410
Mailing Address - Street 1:13870 ELDER AVE
Mailing Address - Street 2:STE 1H
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-6001
Mailing Address - Country:US
Mailing Address - Phone:718-886-5410
Mailing Address - Fax:718-886-6954
Practice Address - Street 1:13870 ELDER AVE
Practice Address - Street 2:STE 1H
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-6001
Practice Address - Country:US
Practice Address - Phone:718-886-5410
Practice Address - Fax:718-886-6954
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-20
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043257-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY9176501OtherDORAL