Provider Demographics
NPI:1841238367
Name:ELSHAFIE, MOHAMED (DDS)
Entity Type:Individual
Prefix:MR
First Name:MOHAMED
Middle Name:
Last Name:ELSHAFIE
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 1:400 MOBIL AVE
Mailing Address - Street 2:SUITE A-4
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010
Mailing Address - Country:US
Mailing Address - Phone:805-484-3599
Mailing Address - Fax:805-484-0747
Practice Address - Street 1:400 MOBIL AVE
Practice Address - Street 2:SUITE A-4
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010
Practice Address - Country:US
Practice Address - Phone:805-484-3599
Practice Address - Fax:805-484-0747
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-04
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA322311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice