Provider Demographics
NPI:1811036775
Name:GHOBRIAL, EMEEL NASHED (DDS)
Entity Type:Individual
Prefix:MR
First Name:EMEEL
Middle Name:NASHED
Last Name:GHOBRIAL
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 1:628 WEST HOLT BLVD
Mailing Address - Street 2:SUITE # C
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91762-3710
Mailing Address - Country:US
Mailing Address - Phone:909-986-6424
Mailing Address - Fax:909-986-7464
Practice Address - Street 1:628 WEST HOLT BLVD
Practice Address - Street 2:SUITE # C
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91762-3710
Practice Address - Country:US
Practice Address - Phone:909-986-6424
Practice Address - Fax:909-986-7464
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42823122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB4282301OtherDENTICAL
CA518855OtherPIN