Provider Demographics
NPI:1922655018
Name:EL MADHOUN, RANIA (DMD)
Entity Type:Individual
Prefix:
First Name:RANIA
Middle Name:
Last Name:EL MADHOUN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 N 16TH ST APT 804
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-1221
Mailing Address - Country:US
Mailing Address - Phone:770-910-0989
Mailing Address - Fax:
Practice Address - Street 1:2200 ARCH ST STE 102
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-1353
Practice Address - Country:US
Practice Address - Phone:610-220-7052
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-22
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS042423122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist