Provider Demographics
NPI:1659706877
Name:ELNAGGAR, TAMER (DDS)
Entity Type:Individual
Prefix:
First Name:TAMER
Middle Name:
Last Name:ELNAGGAR
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 1:1336 WHISPERING TRL
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92602-0811
Mailing Address - Country:US
Mailing Address - Phone:813-598-0452
Mailing Address - Fax:177-381-5889
Practice Address - Street 1:1336 WHISPERING TRL
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92602-0811
Practice Address - Country:US
Practice Address - Phone:813-598-0452
Practice Address - Fax:177-381-5889
Is Sole Proprietor?:No
Enumeration Date:2013-09-06
Last Update Date:2013-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA62771122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist