Provider Demographics
NPI:1821033549
Name:EL-REFAI, NIVINE Y (BDS,DDS,MSD)
Entity Type:Individual
Prefix:DR
First Name:NIVINE
Middle Name:Y
Last Name:EL-REFAI
Suffix:
Gender:F
Credentials:BDS,DDS,MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3985 MEDINA RD
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-5968
Mailing Address - Country:US
Mailing Address - Phone:330-721-1350
Mailing Address - Fax:330-721-4741
Practice Address - Street 1:3985 MEDINA RD
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-5968
Practice Address - Country:US
Practice Address - Phone:330-721-1350
Practice Address - Fax:330-721-4741
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-17
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300208831223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics